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Natural Orifice Transgastric Endoscopic Surgical Removal of the Gallbladder (NOTESchole)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01174069
Recruitment Status : Completed
First Posted : August 3, 2010
Last Update Posted : September 2, 2019
Northwestern University
Information provided by (Responsible Party):
Lee Swanstrom, The Oregon Clinic

Brief Summary:
Hypothesis: Natural orifice transgastric cholecystectomy with laparoscopic assist will be feasible and have comparable complication rates as standard lap cholecystectomy. Patient benefits will include less pain and scaring.

Condition or disease Intervention/treatment Phase
Cholecystitis Procedure: NOTES assisted laparoscopic cholecystectomy Not Applicable

Detailed Description:

In this study, we propose to use a surgical technique that eliminates the need for a 1.5-2.5 cm umbilical incision. A flexible endoscope will be inserted through the mouth and into the stomach. Using commercially available endoscopes, endoscopic instruments and accessories, a small incision will be made in the gastric wall and the endoscope will be advanced into the insufflated peritoneal cavity. Two to three small laparoscopic trocars will be placed for laparoscopic instrument insertion to manipulate, retract and cut tissue. The flexible endoscope will provide visualization of the surgical field and flexible endoscopic instruments may be used to augment surgical manipulation with the laparoscopic instruments. Once dissected free, the gall bladder will be removed through the stomach and out of the mouth. Commercially available endoscopic clips, sutures and/or tissue anchors will be used to close the gastrotomy; additionally, the gastrotomy will be tested for leaks and laparoscopically oversewn with suture as needed.

Patients will be discharged per the standard of practice for a laparoscopic cholecystectomy. During the hospital stay severity of pain and use of pain medications will be recorded. Length of time spent in the recovery room and in the hospital will also be collected. Patients will return and be evaluated by their surgeon two weeks following their procedure. At this visit, any complications will be noted in the patient's medical record. Additionally at this visit and at the preoperative visit, patients will complete a standardized Quality of Life (QOL) assessment (i.e., SF-36) and perceived pain levels and type and frequency of pain medications will be recorded in the patient's medical record.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 25 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Clinical Outcomes Trial of Laparoscopic Assisted Transgastric Endoscopic Cholecystectomy
Actual Study Start Date : May 2007
Actual Primary Completion Date : October 2015
Actual Study Completion Date : October 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Endoscopy

Arm Intervention/treatment
Experimental: NOTES cholecystectomy Procedure: NOTES assisted laparoscopic cholecystectomy
Surgical removal of the gallbladder using endoscopic instruments.
Other Name: NOTES Cholecystectomy

Primary Outcome Measures :
  1. Postoperative pain [ Time Frame: 30 days ]
    perceived pain levels and type and frequency of pain medications will be recorded in the patient's medical record.

Secondary Outcome Measures :
  1. Perception of surgical outcome [ Time Frame: 30 days post operatively ]
    standardized Quality of Life (QOL) assessment (i.e., SF-36) form filled out by the patient.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Ability to undergo general anesthesia
  2. Age > 18 years of age and < 80 years of age
  3. Ability to give informed consent

Exclusion Criteria:

  1. Acute cholecystitis
  2. Body Mass Index (BMI) > 40
  3. Contraindicated for esophagogastroduodenoscopy (EGD)
  4. Gallstones > 2.5cm in diameter
  5. Gall bladder more than 15cm in length on U/S
  6. Presence of common duct stones
  7. Presence of esophageal stricture
  8. Altered gastric anatomy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01174069

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United States, Oregon
Legacy health System
Portland, Oregon, United States, 97210
Sponsors and Collaborators
The Oregon Clinic
Northwestern University
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Principal Investigator: Christy M Dunst, MD The Oregon Clinic
Study Director: Angi B Gill, RN The Oregon Clinic

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Responsible Party: Lee Swanstrom, MD, The Oregon Clinic Identifier: NCT01174069     History of Changes
Other Study ID Numbers: LHS0701
First Posted: August 3, 2010    Key Record Dates
Last Update Posted: September 2, 2019
Last Verified: August 2019
Keywords provided by Lee Swanstrom, The Oregon Clinic:
Additional relevant MeSH terms:
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Gallbladder Diseases
Biliary Tract Diseases
Digestive System Diseases