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Actively Recruiting

Age: 21Years +
All Genders
ID07615036

AP-NOSES A Prospective Multicenter Registry Evaluating Natural Orifice Versus Abdominal Specimen Extraction in Minimally Invasive Colorectal Surgery

Led by Singapore General Hospital · Updated on 2026-05-29

800

Participants Needed

1

Research Sites

39 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating natural orifice specimen extraction NOSE, a minimally invasive surgical technique for colorectal surgery where the specimen is removed through natural openings like the anus or vagina instead of an abdominal incision. This prospective multicenter observational registry compares outcomes of NOSE with traditional transabdominal specimen extraction, focusing on long-term results such as incisional hernia risk and patient-reported experiences. The study aims to provide comprehensive data on wound complications, bowel, urinary and sexual function, and cancer outcomes across several centers in the Asia-Pacific region. The study includes two groups patients planned for NOSE extraction and those planned for transabdominal extraction, both undergoing elective minimally invasive colorectal surgery. Surgical methods, perioperative care, and follow-up remain according to each centers usual practice without mandated changes. Data on surgical details, complications, and oncologic outcomes are collected prospectively, with patient-reported quality-of-life and functional assessments at multiple time points up to two years after surgery. Participants will be followed for up to 24 months after their surgery to evaluate the time to incisional hernia and other complications. Researchers will collect clinical data, patient questionnaires on quality of life, body image, bowel and sexual function, as well as cancer recurrence outcomes. The study uses validated tools such as EQ-5D-5L, Body Image Scale, and Low Anterior Resection Syndrome score. Data are securely stored and no changes to routine care are required, ensuring participant safety and standard treatment continuity.

CONDITIONS

Brief Title

AP-NOSES: A Prospective Multicentre Registry of Natural Orifice Specimen Extraction in Minimally Invasive Colorectal Surgery

Who Can Participate

Age: 21Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 21 years or older
  • Elective minimally invasive colorectal resection (laparoscopic or robotic intent)
  • Planned intact specimen extraction
  • Eligible for natural orifice specimen extraction (NOSE) or transabdominal specimen extraction according to study protocol
  • Ability to provide informed consent
Not Eligible

You will not qualify if you...

  • Emergency colorectal surgery
  • Planned transanal total mesorectal excision (TaTME)
  • Planned ultralow anterior resection with planned anastomosis 3 cm or less from the anal verge
  • Planned abdominoperineal resection (APR)
  • Planned permanent end stoma without restoration of intestinal continuity
  • Planned multivisceral resection
  • Generalized peritonitis or uncontrolled intra-abdominal sepsis
  • Pregnancy
  • Pre-existing ventral or incisional hernia at the planned extraction site
  • Planned specimen extraction through a prior laparotomy incision containing mesh
  • Fixed distal obstruction, severe pelvic stenosis, or other anatomical constraint precluding intact specimen extraction

Research Team

I

Isaac Seow-En, MBBS, FRCSEd

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