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Transluminal Flexible Endoscopic Procedure in Foregut and Urologic Surgery (NOTES)

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ClinicalTrials.gov Identifier: NCT00484783
Recruitment Status : Completed
First Posted : June 11, 2007
Last Update Posted : December 16, 2014
Information provided by (Responsible Party):
Jeffrey Marks, MD, University Hospital Case Medical Center

June 7, 2007
June 11, 2007
December 16, 2014
August 2006
January 2009   (Final data collection date for primary outcome measure)
30 day Post-op NOTES feasibility outcomes: [ Time Frame: 30 days post-op ]
  • Number of successful NOTES access attempts
  • Number of failed NOTES access attempts
  • Injury to collateral organs or structures
  • Time to gain access to peritoneal cavity
  • Necessary balloon dilator size required for translumenal passage of endoscope
Not Provided
Complete list of historical versions of study NCT00484783 on ClinicalTrials.gov Archive Site
  • 30 Day Post-OP Evaluation of Efficacy of NOTES access when compared to historical control groups undergoing laparoscopic access during foregut surgery [ Time Frame: 30 Day Post-OP ]

    Description: Mortality Post-Op Mobidity repeat sugery Intra-Op or Post-Op RBC Transfusion Intra-Abdominal Abscess Superficial Surgical Site Infection Antibiotics>24th Post-Op

    Safety Issue?: Yes

  • 30 Day NOTES Post - Op Evaluation of Adequacy of Abdominal Exploration [ Time Frame: 30 Day Post - Op ]
    Description: Identification of Specified Abdominal and Pelvic Organs Time to Adequately Visualize Specified Abdominal and Pelvic Organs Comparitive findings between standardaized abdominal exploration between laparoscopy and NOTES techniques
Not Provided
Not Provided
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Transluminal Flexible Endoscopic Procedure in Foregut and Urologic Surgery
Prospective Evaluation of the Intraoperative Use of Translumenal Flexible Endoscopes During Combined Flexible and Laparoscopic Foregut and Urologic Surgery
NOTES access is safe and feasible in the controlled human setting and comparable to standard-of-care surgical techniques. NOTES exploration of the abdomen provides adequate visualization comparable to laparoscopy.

This is a prospective clinical trial to evaluate the feasibility of obtaining peritoneal cavity access from natural orifice translumenal endoscopic surgery (NOTES) during combined laparoscopic-endoscopic foregut surgery. Post-operative course will be compared with a historical chart-review control group of patients undergoing standard laparoscopic foregut and urologic surgery.

The study group will be compiled by open enrollment for male and female adult subjects scheduled for combined laparoscopic-endoscopic surgery of the stomach, abdominal esophagus, prostate, bladder, proximal small intestine or who meet inclusion and exclusion criteria. The historical chart-review control group will be randomly chosen from patients from 2003-2006 having undergone combined laparoscopic-endoscopic surgery of the foregut, prostate, or bladder and as determined by CPT coding.

The purpose of the study is to determine if NOTES access and abdominal exploration is feasible, safe, offers comparable visualization to laparoscopy in a controlled human setting.

Not Provided
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
  • Gastric Foreign Body, Nos
  • Disorder of Abdomen (Disorder)
  • Foreign Body in Esophagus
  • Prostatic Diseases
  • Disease of Small Intestine
  • Procedure: Natural Orifice Transluminal Endoscopic Surgery (NOTES)
    Patients will have the standard laparoscopic procedure and the NOTES procedure will be added. The surgical procedure will require two operating teams: one led by a laparoscopic surgeon, the other by an endoscopic surgeon. During the usual course of the surgery, the flexible endoscope will be passed through the mouth urethra top gain access to the peritoneal cavity.
    Other Name: NOTES Surgery
  • Procedure: Natural Orifice Translumenal Endoscopic Surgery (NOTES)
    chart review of historical data from control group
    Other Name: NOTES Surgery
  • Experimental: Prospective
    Subjects scheduled to receive procedure
    Intervention: Procedure: Natural Orifice Transluminal Endoscopic Surgery (NOTES)
  • Historical
    Chart review control group
    Intervention: Procedure: Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
January 2009
January 2009   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients undergoing an already combined laparoscopic and endoscopic foregut procedure with general anesthesia
  • Patients undergoing a prostatectomy or cystectomy with general anesthesia
  • All patients will have a planned gastrotomy for exploration, foreign body removal, or removal of tissue, making it a contaminated case or a planned cystotomy or urethrotomy for exploration, foreign body removal or removal of tissue such as prostatectomy or bladder resection.
  • No overwhelming medical co-morbidities
  • Subject is 18 years of age or older
  • Subject is his or her own medical decision maker
  • Subject agrees to participate, fully understands content of informed consent form, and signs the informed consent form

Exclusion Criteria:

  • Patients undergoing a non-palliative procedure in the face of resectable adenocarcinoma of the foregut or genitourinary tract
  • Linitis Plastica
  • Evidence of Active Bowel Obstruction
  • Patients with history of oropharyngeal, esophageal, or gastric adenocarcinoma.
  • Esophageal stricture prohibiting passage of an endoscope
  • Urethral stricture prohibiting passage of an endoscope
  • Emergent Surgery
  • At any time during pre-operative or intra-operative periods, evidence of unresectability is demonstrated
  • Any intra-operative condition prior to surgical resection that results in abortion of the surgical procedure
  • Any contraindication to surgery
  • Pregnancy or actively breastfeeding women
  • Prisoners or Wards of State
Sexes Eligible for Study: All
18 Years to 75 Years   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
United States
Not Provided
Not Provided
Jeffrey Marks, MD, University Hospital Case Medical Center
University Hospitals Cleveland Medical Center
Not Provided
Principal Investigator: Jeffrey M. Marks, MD University Hospitals of Cleveland/ Institute for Surgical Innovation
University Hospitals Cleveland Medical Center
December 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP