Laparoscopic Surgery

Researchers are evaluating the safety and effectiveness of the Symani Surgical System in microsurgical anastomosis during free tissue transfer and lymphovenous anastomosis surgeries. The study focuses on how well the device maintains vessel connection at the first attempt and monitors any device-related adverse events. Participants include adults with clinical indications for these specific microsurgical procedures. The Symani Surgical System, designed for open microsurgery with articulated and interchangeable instruments, is used during surgeries involving vessels between 0.1 and 2.5 mm in diameter. Participants undergo treatment as part of standard care and may be in either free tissue transfer surgery or lymphovenous anastomosis surgery groups. Those in the lymphovenous anastomosis group complete questionnaires and follow prescribed self-care and compression garment use over the study. Participants provide consent for researchers to access their medical information and agree to attend follow-up visits, completing all study procedures and questionnaires. Researchers measure outcomes including device-related adverse events up to 30 days post-procedure and intraoperative vessel patency at first attempt and prior to closure. Additional assessments include procedure times, suturing details, and technical success. The study runs from 2025 to 2027, with ongoing monitoring during the procedure and follow-up visits.

Researchers are collecting data to assess the safety and performance of the da Vinci SP Surgical System, Instruments, and Accessories during hepatopancreaticobiliary HPB and foregut surgeries. These surgeries include cholecystectomy, fundoplication, gastrectomy, distal pancreatectomy, pancreaticoduodenectomy, esophagectomy, and hepatectomy for both benign and malignant diseases. The study is designed as a prospective, single-center investigation focusing on these procedures. Participants will be grouped into four stages based on their diagnosed condition, with each participant undergoing one surgical operation using the da Vinci SP Single-Port Robotic Surgical System. Stage One includes patients undergoing cholecystectomy or hiatal hernia repair with fundoplication. Stage Two involves gastrectomy or distal pancreatectomy. Stage Three covers pancreaticoduodenectomy or esophagectomy, and Stage Four includes hepatectomy. The robotic system is designed to enable minimally invasive single-port surgery through a surgeon console, vision cart, and patient cart with camera and instruments. During the study, participants will be monitored through various assessments including operative time, blood loss, intraoperative and postoperative complications, physical status, survival, disease recurrence, and readmission rates. Follow-up evaluations occur up to five years to track outcomes such as adverse events, positive resection margins, lymph node yield, and overall survival. Participants are followed closely after surgery through hospital discharge and at scheduled intervals to provide comprehensive safety and performance data for the system.

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 37C 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.

The trial investigates the immediate effects of inspiratory muscle training with and without visual feedback using a mobile application in patients undergoing lobectomy via video-assisted thoracic surgery for lung cancer. It aims to assess how visual feedback influences exercise motivation, patient adherence, perception of breathlessness, usability, and patient satisfaction during postoperative recovery. The study focuses on clinically stable lung cancer patients aged 18 to 75 years scheduled for lobectomy. Participants perform two sessions of inspiratory muscle training on postoperative day 1. One session involves conventional training without visual feedback, and the other uses a smart adaptor connected to a mobile app to provide visual feedback. Both sessions use a threshold-loading device set at 40% of maximal inspiratory pressure, with three sets of ten breaths each. The order of these sessions is randomized, and a rest period of at least two hours separates them. Before surgery, participants undergo assessments including respiratory muscle strength measurement and clinical data collection. On the day of training, exercise motivation, dyspnea perception, patient satisfaction, and usability of the mobile app are evaluated immediately after each session. Data from the mobile application, such as successful breaths and training duration, are also recorded. The study measures immediate impacts to guide future integration of technology-supported pulmonary rehabilitation after lobectomy.

Researchers are evaluating how artificial intelligence AI can improve safety during laparoscopic cholecystectomy, a minimally invasive gallbladder removal surgery. This study compares surgeries guided by AI tools to standard procedures without AI, focusing on whether AI helps surgeons achieve the Critical View of Safety, a key step to reduce the risk of serious complications. This randomized controlled trial includes surgeons or fellows performing the procedures and aims to collect feedback on AI use and surgical safety outcomes. The study involves 10 surgeons or fellows and 50 adult patients undergoing laparoscopic cholecystectomy at two hospital sites. Participants are randomly assigned to either the control group using standard surgical care or the intervention group where surgeons receive real-time guidance from two AI models displayed on a monitor during surgery. The AI models highlight safe and unsafe dissection zones and provide text feedback on achieving surgical safety milestones. Surgeons can toggle or turn off AI guidance as needed. Procedures are recorded for post-operative review by expert surgeons. During the study, researchers will collect internal laparoscopic recordings, surgeon feedback immediately after surgery, observational notes during procedures, and review patient charts up to 30 days post-operation. The primary outcome is the rate at which surgeons achieve the Critical View of Safety, monitored for up to one year after surgery. Secondary outcomes include the safety of dissections, surgeon experience with AI, and short-term patient outcomes. The study lasts from surgery through one year of follow-up for outcome analysis.

Researchers are evaluating the effectiveness of Serratus Posterior Superior Intercostal Plane SPSIP block compared to Intercostal Nerve ICN block for managing pain after video-assisted thoracoscopic surgery VATS. This study aims to compare these two methods in terms of controlling postoperative pain, reducing opioid use, minimizing respiratory complications after surgery, and improving patient satisfaction measured by a 5-point Likert scale. In this prospective observational study, patients receive both the SPSIP block and the ICN block for pain relief after surgery. The SPSIP block is done by an anesthesiologist using ultrasound guidance right after skin closure and before the breathing tube is removed. The ICN block is performed by the surgeon under direct vision just before skin closure. During surgery, patients also receive paracetamol and dexketoprofen. After surgery, patients use a patient-controlled analgesia PCA pump with tramadol, and if pain remains high, rescue doses of dexketoprofen are given. Participants will have their pain levels assessed at multiple times up to 24 hours after surgery using the Numerical Pain Rating Scale at rest and while coughing. Researchers will track total opioid use, rescue analgesic use, any complications, and patient satisfaction 24 hours after surgery. This thorough monitoring helps understand the benefits and potential risks of both pain control methods in the early recovery period.

This research evaluates the use of the AnalgesiaNociception Index ANI to guide desflurane anesthesia during laparoscopic cholecystectomy in adults aged 19 to 65 years with good physical health ASA I-II. ANI measures parasympathetic tone to assess pain and analgesia balance, aiming to improve opioid titration, reduce anesthetic consumption, and stabilize hemodynamics during surgery. Participants are randomly assigned to either an ANI-guided group or a standard care group. Both groups receive general anesthesia with propofol induction followed by maintenance with desflurane and remifentanil. The ANI-guided group adjusts desflurane doses based on ANI values and BIS monitoring, while the control group follows standard vital sign and BIS-based titration. ANI is monitored in both groups but only guides dosing in the ANI group. Recovery includes neuromuscular monitoring and use of sugammadex for muscle relaxation reversal. During the study, participants undergo continuous monitoring of heart rate variability, blood pressure, and baroreflex sensitivity to assess autonomic function. Outcomes measured include desflurane concentration, emergence time, postoperative pain, hemodynamic stability, length of stay in recovery, need for additional pain medications, nausea and vomiting incidence, and patient satisfaction. Data collection spans from anesthesia induction through surgery and up to 24 hours postoperatively, with safety and recovery closely tracked.

Researchers are evaluating the use of anrikefon, a new type of pain medicine that targets specific receptors related to visceral pain, for managing pain after laparoscopic surgery. This study focuses on patients undergoing laparoscopic colorectal surgery, aiming to find the best dose of anrikefon given through a patient-controlled intravenous analgesia PCIA pump. The goal is to specifically reduce visceral pain, which is often underestimated and not well controlled by usual pain medicines like morphine. Participants will receive postoperative pain management with one of four treatments high-dose anrikefon, medium-dose anrikefon, low-dose anrikefon, or morphine. Each treatment is delivered via a PCIA pump programmed to give an initial dose followed by patient-controlled bolus doses with a lockout period, over 48 hours. The treatments are combined with other pain control methods like nerve blocks for somatic pain and nonsteroidal anti-inflammatory drugs NSAIDs for inflammatory pain as part of a multimodal approach. During the study, participants will be monitored closely for pain levels at rest and with movement over 48 hours after surgery using pain intensity measures. Researchers will assess the area under the curve AUC of visceral and overall pain to evaluate effectiveness. Safety and side effects will also be observed. The study is designed as a randomized, double-blind, active-controlled trial, helping determine the feasibility of a larger future study and optimal dosing for anrikefon in this setting.

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.

Researchers are evaluating whether adding a Serratus Anterior Plane Block SAPB to the standard Rhomboid Intercostal Block RIB improves postoperative pain control in patients undergoing Video-Assisted Thoracoscopic Surgery VATS. This randomized controlled trial addresses the challenge of pain after VATS, aiming to reduce opioid use and improve patient satisfaction by combining two regional anesthesia techniques targeting different nerve pathways. Participants are divided into two groups one receives RIB alone, and the other receives RIB plus SAPB within 24 hours after RIB. Both blocks are performed under ultrasound guidance to provide targeted pain relief. The study compares pain levels, opioid consumption, and patient satisfaction between the two groups during the first 48 hours after surgery. During the study, pain severity will be measured using the Visual Analog Scale VAS at multiple time points within 48 hours post-surgery. Researchers will also track opioid use and collect patient satisfaction data through questionnaires. Safety and any adverse effects related to the anesthesia techniques will be monitored. The trial involves adult patients aged 18 to 70 undergoing VATS, with participation lasting through the immediate postoperative period for assessment.