Hysterectomy

Researchers are evaluating the safety and effectiveness of the Symani Surgical System in microsurgical anastomosis during free tissue transfer surgery and lymphovenous anastomosis surgery. This observational study aims to assess the device's performance in real-world settings, focusing on the rate of successful vessel connection in the first surgical attempt and the absence of device-related adverse events. Participants will receive standard surgical care using the Symani Surgical System, which offers articulated, interchangeable instruments designed for open microsurgery procedures. The study includes patients undergoing free tissue transfer of the breast or extremities and those having lymphovenous anastomosis surgery for lymphedema. During the trial, participants will have their surgical procedures assessed and may complete questionnaires if undergoing lymphedema procedures. Throughout the study, researchers will monitor the safety and effectiveness of the device by evaluating intraoperative vessel patency and tracking any adverse events up to 30 days after surgery. Participants will be asked to allow access to their medical information, attend follow-up visits, and complete all study procedures and questionnaires. The total participation covers the surgery period and a 30-day post-surgery follow-up to ensure comprehensive safety and outcome monitoring.

Researchers are evaluating the effects of heated humidified high flow nasal cannula (HFNC) oxygen therapy compared to conventional nasal cannula oxygen therapy in patients with gynecologic tumors who are at high risk for post-operative pulmonary complications (PPC). The study focuses on women undergoing gynecological surgery and aims to measure the occurrence of PPC such as postoperative hypoxemia, atelectasis, and pneumonia. Secondary outcomes include improvements in postoperative oxygenation, antibiotic use, length of hospital stay, and any adverse events related to oxygen therapy. Participants are randomly assigned to one of two groups: the HFNC group receives heated humidified high flow nasal cannula oxygen therapy on the day of surgery and the first day after surgery, with oxygen saturation maintained between 92% and 95%. The control group receives conventional nasal cannula oxygen therapy during the same time frame, also maintaining oxygen saturation at 92% to 95%. Both groups have chest CT scans reviewed 36 to 48 hours after surgery. The HFNC device can provide oxygen concentrations ranging from 21% to 100% with heated and humidified gas at 37°C and a maximum flow of 70 liters per minute. During the study, participants will be monitored for postoperative pulmonary complications over seven days after surgery. Researchers will also assess total hospitalization days, oxygen therapy usage, antibiotic use, postoperative oxygenation, and any adverse events within two to seven days post-surgery. The study includes scheduled chest CT scans and continuous oxygen saturation monitoring to track participant outcomes. The study is sponsored by Sichuan Cancer Hospital and Research Institute and is expected to continue until the end of 2025.

Researchers are evaluating an educational handout designed for transgender and non-binary individuals assigned female at birth who are considering gender-affirming hysterectomy with or without ovary removal. The study aims to assess the impact of this handout on patients' understanding of the benefits and risks of retaining or removing ovaries before surgery. This interventional trial is randomized and does not involve masking or blinding. The intervention involves providing an educational handout to a group of participants prior to their surgical consultation at the time of the initial survey. Participants are randomly assigned to either receive the handout plus a survey or just the survey without the handout. This approach allows researchers to compare knowledge and decisional conflict between the groups. Participants will complete surveys to measure their decisional conflict score on the first day of the study. The researchers will monitor how the educational material influences participants' decisions about surgery. The study includes adults aged 18 to 65, with follow-up limited to the initial consultation period. The total duration and further follow-up details are not specified.

This research aims to evaluate the performance and safety of the HARMONIC 700 Shears device when used according to its instructions in both pediatric and adult surgical procedures. The study includes pediatric general surgeries and adult general, gynecological, urological, and thoracic surgeries. It is designed as a prospective, single-arm, multi-center observational study to collect data in a real-world post-market setting. During the study, surgeons will use the HARMONIC 700 Shears device following their standard surgical methods and the device's instructions for use. The study will capture data from these procedures without additional interventions beyond necessary clinical care. Participants include children under 18 undergoing non-emergency surgeries and adults undergoing elective surgeries, with at least one vessel transection performed using the device. Participants will be monitored from the time of surgery through hospital discharge and again about 28 days afterwards. Researchers will assess the success of vessel sealing during surgery and track any device-related adverse events for up to approximately one year and seven months. The main outcomes include the number of vessel transections achieving a certain level of hemostasis and safety events related to the device.

Women undergoing gynecologic oncology surgery often experience significant preoperative anxiety due to concerns about cancer diagnosis, survival, loss of reproductive organs, body image, and sexual health. This anxiety can negatively affect physiological parameters such as heart rate, blood pressure, respiratory rate, and oxygen saturation, increasing surgical risks and discomfort. Researchers are evaluating whether a virtual reality (VR) intervention can reduce this anxiety and improve patient satisfaction before surgery in a randomized controlled trial. Participants will be randomly assigned to either an intervention group receiving a 20-minute virtual reality relaxation session using visual and auditory stimuli delivered via a VR headset, or a control group receiving standard preoperative care. Anxiety levels and physiological parameters will be measured immediately before and after the intervention or standard care session. Patient satisfaction with the preoperative experience will be assessed once immediately after the intervention and before surgery. During the study, women aged 18 years or older with confirmed gynecological cancer scheduled for their first laparotomy surgery will participate. Assessments include anxiety scoring, blood pressure, heart rate, respiratory rate, and oxygen saturation before and after the intervention. Patient satisfaction will be evaluated before surgery. Safety and adherence will be monitored, including observation for any medical complications or withdrawal. The study aims to provide evidence for VR as a nurse-led, non-invasive method to enhance preoperative care in gynecologic oncology surgery.

Gynecologic cancers are increasing worldwide, making it crucial to improve care around the time of surgery. This research compares two common tools used to predict risks during onco-gynecologic surgeries: the Charlson Comorbidity Index (CCI), which focuses on patients' other medical conditions, and the POSSUM score, which includes both physical health and surgery details. The study aims to see how well these tools predict complications, hospital stay length, and death within 30 days after surgery to help doctors better manage risks. The study observes patients undergoing planned onco-gynecologic surgeries for cancers such as ovarian, cervical, uterine, and vulvar cancer. Researchers will assess each patient using the CCI and POSSUM scores based on their medical history and surgery factors. These scores will then be compared to actual outcomes like surgical complications and mortality. This approach does not involve experimental treatments but uses these risk tools to evaluate their accuracy and usefulness. Participants will be monitored from the day of surgery until hospital discharge, up to 30 days, to track complications, blood loss, blood pressure issues, ICU admissions, reoperations, heart or kidney problems, lung complications, and survival. The study collects detailed clinical data and anesthesia records to compare the two scoring methods. This information aims to improve teamwork among doctors and nurses and enhance patient safety during complex gynecologic cancer surgeries.

Researchers are evaluating two different pain relief methods for women undergoing elective abdominal hysterectomy, a common surgery especially after cesarean section. The study compares intrathecal morphine and bilateral transversus abdominis plane (TAP) block to improve postoperative pain control while minimizing opioid use and related side effects. This research is sponsored by Ataturk Training and Research Hospital and seeks to optimize recovery after surgery through better pain management strategies. Participants will receive either intrathecal morphine, administered via a spinal injection before anesthesia, or a bilateral TAP block using ultrasound guidance and bupivacaine. Both methods are given prior to surgery to help manage pain afterward. The study is randomized and quadruple-masked to fairly compare these two analgesic techniques. During the study, participants’ opioid use within the first 24 hours after surgery will be closely monitored as the main outcome. Researchers will also assess pain levels at rest and during movement, quality of recovery using a specific questionnaire, and any adverse events within 24 hours postoperation. The study involves careful follow-up during this period to evaluate the safety and effectiveness of the pain control methods.

Researchers are evaluating the recovery and safety of patients undergoing robotic assisted hysterectomy, comparing those who go home the same day (day-care) to those who stay at least one night in the hospital. The study includes patients with both benign conditions and endometrial cancer. Quality of life after surgery will be measured using the EQ-5D-5L questionnaire at multiple time points to assess recovery speed and patient satisfaction. Participants are randomly assigned to one of two groups: the experimental group goes home the same day as surgery, while the control group stays overnight in the hospital. The study is conducted across three hospitals, with benign cases treated at two sites and endometrial cancer cases at a third. An additional questionnaire about satisfaction with hospital stay length will be given 30 days after surgery. During the study, patients will complete quality of life questionnaires before surgery and then at 3, 7, and 30 days after surgery. Researchers will also monitor surgical complications, readmissions, reoperations, and sick leave within 30 to 60 days post-surgery. Socioeconomic costs will be evaluated, and the total participation period spans from surgery to 60 days after. Safety and patient recovery outcomes are carefully recorded throughout.

Researchers are evaluating the effects and safety of dexamethasone palmitate compared to traditional dexamethasone for preventing postoperative nausea and vomiting (PONV) after open surgery. Although dexamethasone is commonly used to reduce PONV, some patients still experience symptoms within 24 hours after surgery. Dexamethasone palmitate has a longer-lasting anti-inflammatory effect and fewer side effects, making it a promising option for managing PONV. Participants will be randomly assigned to one of two groups. One group will receive an intravenous injection of dexamethasone palmitate 8 mg (containing 5 mg dexamethasone) after anesthesia induction and before surgical incision. The other group will receive an intravenous injection of dexamethasone 5 mg at the same time. The trial compares these treatments in patients undergoing elective open surgeries such as spinal, chest, or abdominal surgery. During the study, researchers will monitor participants for the incidence and severity of PONV at multiple time points within 72 hours after surgery. They will also track the use of rescue antiemetic medications, participant satisfaction with PONV management, pain levels using the VAS scale, quality of postoperative recovery, length of hospital stay, and safety outcomes up to one month after surgery. The main outcome is the occurrence of PONV within the first 24 hours postoperatively. Participation lasts through the surgery and follow-up periods as described.

Researchers are evaluating whether adding azithromycin to the usual antibiotic cefuroxime before hysterectomy can reduce infections that occur after the surgery. The study focuses on women undergoing hysterectomy for non-cancerous reasons and aims to see if this combination lowers the risk of deep infections within 30 days post-operation. It also looks at other infections like superficial wound infections, urinary tract infections, fever episodes, and possible side effects of these antibiotics. Additionally, the study investigates the role of bacterial vaginosis and the vaginal microbiome in these infections. Participants are randomly assigned to receive either azithromycin 500 mg orally when they arrive at the hospital on the day of surgery plus a single dose of cefuroxime (1.5g for those with body mass index under 30 or 3g for BMI 30 or above) before the surgical incision, or a placebo plus the same cefuroxime dose. The azithromycin or placebo is given as two tablets by mouth, and the cefuroxime is given once intravenously in the operating room. This design is triple-blinded to compare the effects fairly. During the study, researchers monitor participants for signs of deep infections or other infections and fever from day 1 to day 30 after hysterectomy. Assessments include clinical evaluations and possibly electrocardiograms to check heart rhythm safety. The main outcome measured is the number of deep infections occurring within 30 days post-surgery. The study runs until December 2030, with participants followed closely during this 30-day period to track infections and any side effects from the antibiotics.