Robotic 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.

This observational study is designed to assess kidney blood flow in adults undergoing planned minimally invasive abdominal surgery. It focuses on evaluating how renal perfusion changes during and after surgery using two non-invasive methods Doppler ultrasonography-derived Renal Resistive Index RRI and Near-Infrared Spectroscopy NIRS-derived regional renal oxygen saturation rSO2. The study aims to understand the effects of surgery-related factors on kidney function and the possible development of acute kidney injury. Participants will have kidney blood flow measurements taken at specific times after anesthesia induction, during the creation of pneumoperitoneum, just before removing the breathing tube, and one hour after extubation. These measurements will be correlated with clinical data such as intra-abdominal pressure, surgery duration, fluid intake, urine output, and postoperative kidney function. The study will gather detailed patient information including demographics, comorbidities, and intraoperative variables. Throughout the study, researchers will monitor perioperative kidney blood flow and evaluate its relationship with postoperative outcomes like acute kidney injury. The data collection includes ultrasound and NIRS assessments, clinical and laboratory tests, fluid balance, and ventilatory parameters. This will help to improve understanding of kidney perfusion changes during minimally invasive surgery and may guide better kidney protection strategies in the future.

Researchers are evaluating two collagenated xenogeneic bone substitutes, GTO4 and GenOs4, combined with a minimally invasive surgery called the Non-Incised Papilla Surgical Approach NIPSA to treat intrabony periodontal defects in patients with Stage III periodontitis. This multicenter randomized controlled trial aims to compare clinical, radiographic, microbiological, and molecular outcomes, including clinical attachment gain, defect healing, and biological markers of bone regeneration. Participants will be randomly assigned to receive regenerative periodontal surgery using either GTO4 or GenOs4 bone substitutes together with the NIPSA technique. The surgery involves a special incision approach designed to preserve soft tissues and improve wound healing. The study will be conducted at two dental schools and will follow patients for 6 months after surgery. Clinical and radiographic assessments will be performed at baseline, immediately after surgery, and at 6 months. During the study, participants will have clinical measures such as probing depth, attachment level, bleeding, and plaque recorded. Microbiological tests and molecular analyses of gene expression related to bone remodeling and vascularization will be done. Early healing and postoperative pain will also be evaluated. The main outcome is clinical attachment level gain at 6 months. The study will help determine differences in regenerative potential between the two bone substitutes when used with this minimally invasive surgical method.

Researchers are evaluating pain control methods following robotic lung surgery. This prospective randomized single-blinded clinical trial compares two approaches wound infiltration and intercostal nerve block using either liposomal bupivacaine or a combination of bupivacaineepinephrine plus dexamethasone. Liposomal bupivacaine is a newer local anesthetic that has not yet been compared to the established bupivacaineepinephrine plus dexamethasone combination in this surgical context. Participants will be randomly assigned to one of two groups. One group will receive an intercostal nerve block and wound infiltration with 266 mg of liposomal bupivacaine combined with 24 ml of 0.5% bupivacaine. The other group will receive intercostal nerve block and wound infiltration with 42 ml of 0.5% bupivacaineepinephrine plus 8 mg dexamethasone during their robotic lung resection surgery. During the study, participants pain levels will be assessed using the Visual Analogue Scale 24 hours after surgery. Researchers will monitor and compare pain control effectiveness between the two treatments. The trial is led by The Cooper Health System and includes adults aged 18 to 90 undergoing robotic wedge resection or lobectomy for lung masses. The studys design includes randomized allocation and double masking to ensure unbiased results.

Robotic-assisted laparoscopic surgery is increasingly used, especially for older and more fragile patients who may not tolerate major open surgery. This research focuses on the challenges to heart function during robotic surgery involving a steep 30-degree head-down tilt Trendelenburg position, which can increase the hearts workload. The study compares patients with normal heart function to those with systolic heart failure under these conditions to understand circulatory effects better. Participants undergo preoperative echocardiography to classify heart function as normal or decreased ejection fraction 45% or lower. During surgery, heart performance is monitored using an esophageal doppler device, while brain oxygen levels are measured by optical spectrophotometry. Measurements are taken before anesthesia, during Trendelenburg positioning, at the start of the pneumoperitoneum carbon dioxide insufflation, and after returning to a flat position. Throughout the study, standard anesthesia parameters and various cardiac output measures are recorded to analyze heart workload changes. The main outcome is the change in stroke volume during Trendelenburg positioning and pneumoperitoneum within 15 minutes. Secondary outcomes include changes in systemic vascular resistance, pulse pressure variation, peak velocity, stroke volume variation, flow time corrected, and regional brain oxygen saturation. This observational study helps identify which patients may be at risk of heart complications during robotic surgery and informs safer surgical decisions.

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 types of lymphadenectomytransperitoneal and transvaginal paracervicalduring the lymphadenectomy phase of endometrial cancer staging surgery using V-NOTES, a new and advanced surgical approach. This randomized, prospective, controlled study aims to optimize the V-NOTES technique for staging early-stage endometrial cancer by comparing surgical and functional outcomes between the two methods. Patients diagnosed with endometrial cancer through biopsy and imaging are enrolled and randomly assigned to one of the two lymphadenectomy groups. In the transvaginal paracervical lymphadenectomy group, patients undergo V-NOTES surgery beginning with methylene blue dye injection around the cervix, followed by sentinel lymph node mapping, hysterectomy, and removal of ovaries and fallopian tubes. The transperitoneal lymphadenectomy group receives V-NOTES surgery starting with methylene blue injection, anterior and posterior colpotomies, placement of the V-NOTES device, hysterectomy, and then lymph node removal through peritoneal dissection. Both groups receive similar surgical procedures with differences in lymphadenectomy approach. Participants will be assessed during surgery and hospitalization for operation duration, bleeding, lymph node removal, and complications. Follow-up evaluations include postoperative pain and sexual function at 3 and 6 months. Tumor pathology and other surgical outcomes are monitored up to the study completion. The study duration covers recruitment from March to December 2025 with ongoing follow-up through early 2026. Data will be collected on surgical safety, effectiveness of lymph node mapping, and recovery measures.

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.

Intracerebral hemorrhage ICH, a type of stroke causing significant death and disability, is being studied to see if early minimally invasive endoscopy-guided surgery improves patient outcomes compared to standard medical care. This trial focuses on adults with spontaneous supratentorial ICH, aiming to begin surgery within 8 hours of symptom onset. The study is a multicenter, randomized clinical trial led by Radboud University Medical Center, investigating both functional recovery and biological changes after treatment. Participants are randomly assigned to receive either minimally invasive endoscopy-guided surgery plus standard medical management or standard medical management alone. The surgical procedure uses neuronavigation-integrated devices approved for this purpose. Surgery must start within 8 hours of symptoms, and the trial includes detailed monitoring of brain imaging and immune profiles in a subgroup. The standard care group receives blood pressure management, stroke unit admission, and supportive care. Participants will be followed for up to one year with assessments at 6 days, 90 days, 180 days, and 365 days including functional scales like the modified Rankin Scale, stroke severity scores, quality of life questionnaires, and safety monitoring for complications or death. Imaging studies at baseline, 24 hours, and day 6 assess clot and edema changes. The trial also evaluates cost-effectiveness of the surgical approach. Overall participation spans up to one year with multiple clinical and imaging evaluations.