Laparotomy

Researchers are evaluating the use of transversus abdominis plane (TAP) block with different adjuvants to improve pain relief after laparotomy surgery. This study compares the addition of dexamethasone or dexmedetomidine to bupivacaine in patients aged 25 to 65 years with ASA Class I or II status. The goal is to assess which combination provides longer-lasting postoperative analgesia and reduces the need for additional pain medication. Participants will be randomly assigned to one of two groups. Group A receives a TAP block with 18ml of 0.25% bupivacaine plus 2ml of dexamethasone (8mg). Group B receives the same bupivacaine dose plus 2ml of dexmedetomidine (1µg/kg diluted in saline). The TAP block is administered bilaterally under ultrasound guidance immediately after surgery, using a needle guided between the internal oblique and transversus abdominis muscles. Patients are monitored for complications like local anesthetic toxicity or hematoma. During the 24-hour postoperative period, patients' pain levels will be measured using a Visual Analogue Scale (VAS) at several time points. If pain is insufficiently controlled (VAS ≥4), rescue analgesia with IV ketorolac will be provided and the time to first rescue dose recorded. Additional assessments include monitoring nausea, vomiting, heart rate, and blood pressure. The primary outcome is the duration until the first request for rescue analgesia, with secondary outcomes focused on pain scores over 24 hours.

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.

This research aims to compare the rates of pain and common bile duct injuries in patients undergoing laparoscopic gallbladder removal surgery using either low pressure or high pressure pneumoperitoneum. Laparoscopic cholecystectomy is a common minimally invasive procedure to treat gallstones and related conditions, with millions performed annually. The study addresses how different pressure levels during surgery may affect post-operative pain, including shoulder pain, and the risk of bile duct injury, which is a serious complication with increased incidence in laparoscopic techniques. The study compares two groups: one receiving low-pressure pneumoperitoneum at pressures between 6 and 10 mmHg, and the other receiving high-pressure pneumoperitoneum at 12 to 15 mmHg or higher. Pneumoperitoneum is created by introducing carbon dioxide gas into the abdomen to allow better visualization and surgical access. While high pressure may improve surgical view and reduce operative time, it is linked to more post-operative pain and discomfort. Low pressure aims to reduce pain, though it may increase surgery duration due to reduced visibility. The study evaluates these pressure settings to determine their impact on pain and bile duct injury during laparoscopic cholecystectomy. Participants will undergo laparoscopic cholecystectomy with assigned pneumoperitoneum pressure. Researchers will monitor the incidence of post-operative pain and common bile duct injuries over six months. Assessments will include pain measurements and surgical outcomes related to bile duct safety. The study involves random assignment to either low or high pressure groups and single masking. Follow-up will track pain levels and bile duct complications to evaluate differences between the two pressure approaches. The overall goal is to improve patient comfort and safety during this common surgery.

This research aims to analyze the potential benefits of damage control surgery, which involves bowel resection, open abdomen, and delayed anastomosis, in treating patients with Hinchey grade III or IV diverticulitis. The study focuses on comparing this approach to other surgical options like the Hartmann procedure and resection with primary anastomosis, particularly in cases of purulent or fecal peritonitis caused by complicated acute large bowel diverticulitis. The treatment being evaluated is Damage Control Surgery, which includes simple resection, dropping the bowel, and leaving the abdomen open temporarily. This approach is considered an alternative to the Hartmann procedure and primary anastomosis, especially in patients with severe sepsis from diverticulitis. The study observes patients who have undergone surgery with this method to describe its rationale and outcomes. Participants in this observational study will be monitored for outcomes such as mortality and morbidity within 60 days after surgery. Researchers will also assess the rate of upfront Hartmann procedures, length of hospital stay, and time spent in the intensive care unit. The study involves follow-up during this 60-day period to understand the effects and potential benefits of Damage Control Surgery in this patient group.

Researchers are studying the effectiveness of the Deep Rectus Sheath (Preperitoneal) block in adults undergoing open or laparoscopic abdominal surgery. The goal is to see if this ultrasound-guided pain relief technique improves recovery and controls pain better than standard care or other nerve block methods such as TAP, ESP, or QL blocks. This observational clinical study is non-interventional and focuses on routine clinical care outcomes. Participants will receive pain management as per standard practice, which may include systemic analgesia alone, the Deep Rectus Sheath block combined with standard care, or other fascial plane blocks combined with standard care. Details such as the type of block, timing, technique, and local anesthetic dosages will be recorded. All patients will also receive multimodal pain relief following hospital protocols, with opioids reserved for rescue treatment. During the study, participants' recovery quality will be measured using the Quality of Recovery-15 (QoR-15) score at 24 hours after surgery. Pain levels at rest and with movement will be tracked up to 48 hours, along with analgesic use, time to first pain medication request, mobilization time, and any complications. Safety monitoring includes checking for block-related issues and neurological symptoms up to 7 days after surgery. The study is expected to complete within 12 months.

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 comparing two methods for closing the abdomen after laparotomy surgery: Duramesh and polydioxanone sutures (PDS). The goal is to see if Duramesh is not worse than PDS for early surgical site events within one month after surgery and if it is better at preventing incisional hernias within one year. This study also looks at device performance, technical success of the surgery, pain, implant sensation, satisfaction of both patients and surgeons, and quality of life over 12 months. Participants will have their abdominal incision closed using either Duramesh, a device that combines mesh repair and suturing precision, or standard PDS sutures. Duramesh is designed to reduce surgical site events by distributing forces and allowing tissue growth into the repair. The study uses size 1 Duramesh, which is CE-marked, while the comparison group uses 2-0, 0, or number 1 PDS sutures. The study is randomized, with procedures performed during laparotomy surgery, and follow-up evaluations occur at 1 and 12 months after surgery. During the study, participants will be assessed for surgical site events, including wound problems and hernia occurrence, at various times up to 12 months. Researchers will evaluate pain using a numeric rating scale, implant sensation, and satisfaction from both patients and surgeons using 5-point scales. Quality of life will be measured with a health survey at 12 months. Safety, device performance, and any need for additional surgeries related to the device will also be monitored throughout the year-long follow-up.

This research aims to assess the effects of the AbClo abdominal binding device in patients who have undergone abdominal surgery and have an open abdomen. The study focuses on understanding how this device, which helps keep the abdominal wall together, might impact lung pressure, lung volume, and lung function. It also evaluates whether adjusting the breathing machine settings can reduce any negative effects caused by the device's pressure on the lungs. Participants are already using the AbClo device when they join the study. The study involves measuring various aspects of lung function, including physical properties and oxygenation ability, before and after adjusting the device's pressure to the manufacturer's recommended levels. These measurements are taken both on the day of enrollment and on the day of surgery to close the abdomen. During the study, participants will undergo assessments of lung function and pressure changes using the device. Researchers will monitor changes in end-expiratory transpulmonary pressure, lung volume, and oxygenation. The study includes evaluations at enrollment and at surgery closure, with the goal of understanding how the device and its adjustments affect respiratory mechanics in these patients.

Researchers are evaluating the effect of applying a hot compress to the intestines during abdominal surgery on postoperative nausea, vomiting, and bowel function. This randomized study involves patients undergoing abdominal surgery who meet specific criteria such as age and body mass index (BMI). The study aims to determine whether covering the intestines with saline heated to 36°C during surgery affects recovery outcomes like nausea and bowel function. Participants are randomly assigned to one of two groups. The intervention group will have their intestines covered with sterile gauze soaked in saline heated to 36°C during surgery to prevent drying and reduce infection risk. The control group will receive standard care, with intestines covered using gauze soaked in unheated saline. Both groups will undergo routine preoperative and postoperative procedures. Initially, 30 patients per group will be included, with further enrollment based on power analysis. Throughout the study, participants will complete forms and scales including the Patient Introduction Form, Patient Follow-up Form, Quality of Recovery-15 Scale (QoR-15), and Gastrointestinal Symptom Rating Scale (GSRS). Researchers will monitor gastrointestinal function by measuring time to first gas passage, first bowel movement, first normal bowel sounds, and first intake of liquid or semi-solid food. Postoperative gastrointestinal symptoms such as nausea, bloating, pain, and vomiting will also be assessed. The study will continue until early 2026, with careful monitoring of recovery and symptom severity.

Researchers are evaluating two different locoregional anesthesia techniques to manage postoperative pain and aid recovery after a midline laparotomy, a type of abdominal surgery. This randomized controlled trial compares the commonly used epidural analgesia with a newer method called bilateral rectus sheath block. The study aims to understand how these pain relief methods influence patients' quality of recovery after surgery, measured by the Quality of Recovery-15 score. Participants are randomly assigned to one of two groups: one receiving thoracic epidural analgesia, where a catheter is placed in the epidural space to deliver local anesthetic, and the other receiving bilateral rectus sheath block under ultrasound guidance, with anesthetic delivered via catheters on both sides of the abdomen. Both groups undergo the same type of abdominal surgery, and the treatments are part of a multimodal pain management approach during and after surgery. During the study, patients will be monitored for changes in recovery quality on postoperative days 1, 2, and 3, as well as the day before surgery. Assessments include pain control effectiveness, blood pressure effects, nausea, complications related to the analgesic technique, length of hospital stay, bowel function, morphine use, and patient satisfaction up to 30 days after surgery. Catheter placement success, mobility, and other postoperative events are also tracked to understand the impact of each anesthesia method on rehabilitation.