Intraoperative Gamma Probe Localization of the Ureter

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: NCT00587548
Recruitment Status : Terminated (Decided not pursue the study)
First Posted : January 7, 2008
Last Update Posted : September 29, 2010
Information provided by:
Mayo Clinic

Brief Summary:

This study is being done to find a different way to identify the ureters during an abdominal operation.

During some operations, the operating physician must identify where the ureters are to prevent injury to them. Typically, the surgeon calls the urologist to thread a small scope with a camera into the urethra (where the urine comes out) to place a wire into each of the two ureters to locate them. Instead of this procedure, we will inject a small amount of a radioactive chemical dye (TC99-DTPA)through a vein in your arm. The ureters can then be detected by a hand held probe called the 'gamma probe.' The TC99-DTPA dye passes through the body and is excreted through the urine. The goal of this study is that this probe will alert the physician when it placed directly over the ureters since the TC99-DTPA dye will highlight the ureters as the flow of urine goes through them.

Condition or disease Intervention/treatment Phase
Abdominal Surgery Other: Localizing the ureters during surgery Not Applicable

Detailed Description:

The patient population includes those that are undergoing an elective, open, abdominal surgery.

The patient will receive, on average, 4.5mCi of Technetium labeled diethylene-triamine-penta acetate (DTPA) prior to the time of ureteral localization. The Neoprobe 2000 gamma probe will be placed on the field in sterile fashion in a manner similar to that which is performed during a minimally invasive parathyroidectomy or sentinel lymph node biopsy. The surgery will continue until the surgical team feels the time is appropriate for each ureter to be identified. At this point, the surgical team will use the gamma probe to localize the ureter and the attending physician will note either, "yes" or, "no" to their feeling is that they have correctly identified or did not identify each ureter. The surgical team will know that the ureter has been correctly identified when gentle manipulation of the tissue with forceps produces a "vermicular contraction" of the tubular structure suspected to be the ureter. No other tissue and/or structure produces this classic type of contraction. Background gamma counts, gamma counts over the ureter, and time between Tc-DTPA injection and ureteral localization will be recorded for each ureter sought. If the ureter cannot be localized with this technique, and the surgical team feels that it is imperative that the ureters be identified, then the attending surgeon may request a urologist to place stents in the standard, usual fashion.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 16 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Intraoperative Gamma Probe Localization of the Ureter
Study Start Date : January 2006
Actual Primary Completion Date : January 2010
Actual Study Completion Date : January 2010

Intervention Details:
  • Other: Localizing the ureters during surgery
    One-time injection 4.5mCi of 99mTechnetium labeled diethylene-triamine-penta acetate (DTPA) prior to the time of ureteral localization. The Neoprobe 2000 gamma probe will be utilized for ureter location.
    Other Names:
    • 4.5cmCi 99mTechnetium labeled diethylene-triamine-penta acetate (DTPA)
    • Neoprobe 2000 gamma probe

Primary Outcome Measures :
  1. If gamma probe localization of the ureters is possible, the need for ureteral stent placement could be obviated. [ Time Frame: Intraoperative procedure ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Agrees to informed consent.
  • Patients undergoing elective, open, abdominal surgery
  • 18 years or older
  • Normal renal function defined by a serum creatinine less than 1.5mg/dL

Exclusion Criteria:

  • Pregnant or lactating females

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): NCT00587548

United States, Florida
Mayo Clinic Jacksonville
Jacksonville, Florida, United States, 32224
Sponsors and Collaborators
Mayo Clinic
Principal Investigator: Manpreet Grewal, M.D. Mayo Clinic

Responsible Party: Manpreet Grewal, M.D., Mayo Clinic Jacksonville Identifier: NCT00587548     History of Changes
Other Study ID Numbers: 79-06
First Posted: January 7, 2008    Key Record Dates
Last Update Posted: September 29, 2010
Last Verified: September 2010

Keywords provided by Mayo Clinic:
locate the ureters during abdominal surgery

Additional relevant MeSH terms:
Nitric Oxide Donors
Molecular Mechanisms of Pharmacological Action