- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04400669
The Effect of Mechanical Bowel Preparation Prior to Gynaecological Laparoscopic Surgeries on the Surgical Conditions
The Effect of Mechanical Bowel Preparation Prior to Gynaecological Laparoscopic Surgeries on the Pressure of Pneumoperitoneum and Trendelenburg Inclination Angle During the Surgery: A Novel Perspective for Patient Safety
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Mechanical bowel preparation (MBP) has been routinely used prior to minimally invasive gynaecologic procedures (MIGP) hypothetically to improve intraoperative bowel handling and visualization of the surgical field, and also to reduce faecal contamination in the setting of bowel injury and/or resection.
The studies investigating the effect of MBP on MIGP are limited and most of existing data are extrapolated from the reports of colorectal and urological surgery studies.
Besides, evaluation of the surgical workspace visualization and intraoperative bowel handling are far from being objective since they were mostly measured by a 4/5/10-point Likert scales or rated verbally on scales of excellent to poor by the operating surgeons.
In contrary, it is planned to use objective visualize index, and objective surgical conditions to measure whether MBP has any effect or not.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Uzeyir Kalkan, M.D.
- Phone Number: +905428102539
- Email: uzekal@hotmail.com
Study Locations
-
-
-
Aydin, Turkey
- Recruiting
- EgeMed Hospital
-
Contact:
- Uzeyir Kalkan, M.D.
-
Principal Investigator:
- Uzeyir Kalkan, M.D.
-
Samsun, Turkey
- Recruiting
- Samsun Medical Faculty
-
Contact:
- Kadir Bakay, Assoc.Prof.
-
Principal Investigator:
- Kadir Bakay, Assoc.Prof.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Aged 18 years and older
- Able to provide informed consent
- Undergo laparoscopic gynecological surgery for a benign condition
Exclusion Criteria:
- History of previous abdominal surgery
- Clinically significant present or past systemic diseases
- Inability to perform mechanical bowel preparation
- Suspicion of malignancy
- Association with non-gynaecological surgical pathologies
- Severe endometriosis (stage ≥ III according to the classification of the American Society for Reproductive Medicine)
- Psychiatric disorders precluding consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Mechanical Bowel Preparation
Patients will have only clear liquids after a normal breakfast and lunch on the day before surgery and subsequently fasten for 7-9 hours prior to surgery.
Patients will ingest first dose of 45 ml oral sodium phosphate (NaP) enema (BT ORAL SOLUSYON 45 ML®, Yenisehir Lab.
Tic.
San. Ltd.
Sti, Turkey) at 4 p.m. and a second dose at 8 p.m. in the evening before the scheduled surgery.
|
oral sodium phosphate (NaP) enema
|
Active Comparator: Low fibre diet
Patients will be given detailed instructions about the pre-operative diet (total daily Fibre intake inferior to 10 g) to be used for 3 days prior to surgery.
|
3 days
|
Active Comparator: MBP plus low fibre diet
This group will receive both mechanical bowel preparation and 3-days low fibre diet.
|
3 days low fibre diet preoperative mechanical bowel preparation
|
No Intervention: Control
Control subjects will receive no instructions about the pre-operative diet (free diet).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The surgical visibility of abdomen
Time Frame: After the introduce of first left lateral port
|
A scale title as "Objective Visual Indexing (OVI)" will be used for assessing the visibility of the Douglas pouch and adnexa.
The assessment of the visibility of Douglas pouch and adnexa will be performed under standard pneumoperitoneum pressure (12mmHg) and Trendelenburg inclincation angle (30).
After the first Inspection, scale of VI scoring will be calculated by adding up the points obtained from optical inspection.
Higher scores mean better visuality of the surgical field.
|
After the introduce of first left lateral port
|
The lowest pneumoperitoneum pressure (PP) at standard Trendelenburg inclination angle (TIA).
Time Frame: In the initial phase of the surgery
|
The PP will be increased to 15 mmHg while keeping the TIA same, at 30o.
The surgeon will displace the bowel beginning from the cecum followed by the last ileal loop above the sacral promontory.
Once the bowel was displaced out of the pelvis, the PP will be stepwise decreased by 1 mmHg during 1 min intervals to the lowest pressure where the bowel is to descend towards the pelvis over the pelvic brim and/or where the surgical workspace is not adequate to proceed safely with the planned operation.
This value will be recorded as the lowest PP adequate to proceed safely with the planned surgery at standard TIA (30 degree).
|
In the initial phase of the surgery
|
The lowest Trendelenburg inclination angle (TIA) at standard pneumoperitoneum pressure (PP) adequate to proceed with the planned operation.
Time Frame: In the initial phase of the surgery
|
The PP obtained in outcome 2 will be readjusted to the standard 12 mmHg keeping the TIA same, at 300.
Then, the surgeon will replace the bowel beginning from the cecum followed by the last ileal loop above the sacral promontory.
Once the bowel is displaced out of the pelvis, the TIA will be gradually decreased by 1o with 15 seconds intervals to the degree where the bowel is to descend towards the pelvis over the pelvic brim.
This value will be recorded as the lowest TIA adequate to proceed safely with the planned surgery at standard PP (12 mmHg).
|
In the initial phase of the surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Preoperative patient symptomatology
Time Frame: Right before the surgery
|
Patients will be interviewed in the preoperative holding area or in the patient's room about the acceptability of the intervention (MBP / diet) and adverse pre-operative events, including: nausea, insomnia, headache, thirst, weakness, tiredness, discomfort, abdominal cramps, sleep disturbances.
These symptoms will be scored with using a 10-cm "Visual Analog Score" (VAS).
Higher scores mean worse outcome.
|
Right before the surgery
|
Postoperative pain
Time Frame: at 24th hours
|
The intensity of the postoperative pain was measured by an independent investigator at 24th hours with a 10-cm Visual Analog Score (VAS).
Higher scores mean worse outcome.
|
at 24th hours
|
Complications
Time Frame: At 1st week and 6th week postoperatively or whenever it occurred.
|
Intraoperative complications, at 1st week and 6th week postoperatively, between the groups.
|
At 1st week and 6th week postoperatively or whenever it occurred.
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Kadir Bakay, Assoc Prof, Ondokuz Mayis Universitesi
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- MBP
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Clinical Study Report (CSR)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Patient Preference
-
University of GöttingenCharite University, Berlin, Germany; Georg-Elias-Mueller-Institute of Psychology...Unknown
-
Universitair Ziekenhuis BrusselUnknownPatient Satisfaction | Patient PreferenceBelgium
-
University of Novi SadMerck Sharp & Dohme LLCCompleted
-
University of GöttingenCharite University, Berlin, GermanyUnknown
-
Montefiore Medical CenterCompletedTime | Patient PreferenceUnited States
-
TriHealth Inc.Completed
-
Wake Forest University Health SciencesWithdrawnPatient Satisfaction | Patient Preference
-
University of South FloridaEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsCompleted
-
Kuwait UniversityCompletedTime | Patient Preference | RetentionKuwait
-
University Hospital, GrenobleNot yet recruitingPatient Preference | Advance Care Planning
Clinical Trials on Mechanical Bowel Preparation
-
TC Erciyes UniversityNot yet recruitingPOCD - Postoperative Cognitive Dysfunction | Mechanical Bowel Preparation
-
Hospital Infantil de Mexico Federico GomezUnknownColostomy | Surgical AnastomosisMexico
-
N.N. Petrov National Medical Research Center of...RecruitingRectal CancerRussian Federation
-
European Institute of OncologyCompleted
-
Braintree LaboratoriesCompletedBowel Preparation for ColonoscopyUnited States
-
Nantes University HospitalRecruiting
-
Hamilton Health Sciences CorporationMcMaster UniversityUnknownAnastomotic Leak | Surgical Site InfectionCanada
-
Boston Urogynecology AssociatesUnknown
-
Ningbo No. 1 HospitalCompletedBowel Preparation | Post-polypectomy Bleeding | Urgent ColonoscopyChina
-
Casen Recordati S.L.CompletedBowel Preparation for ColonoscopySpain