Investigating the Use of Fluorescent Imaging and Methylene Blue to Identify and Prevent Ureteric Injuries During Laparoscopic and Open Colorectal Surgery
Overview
- Phase
- Phase 2
- Intervention
- Methylene Blue
- Conditions
- Ureteric Injury
- Sponsor
- University of Oxford
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- To compare the change in ureter identification over time using white light versus intravenous methylene blue in each patient.
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
The main aim of this project is to assess whether intravenous methylene blue can help identify the ureters during open and laparoscopic (keyhole) surgery. The ureters are small tubes that link the kidney to the bladder and, if not properly identified during surgery, may be damaged.
Methylene blue has been safely given to patients for many years and it is fluorescent. It is removed by the kidney and will therefore travel through the ureters. Methylene blue shines brightly (becomes fluorescent) when viewed under red light.
This study aims to compare the ability of methylene blue with white light to identify the location of the ureters during colorectal surgery. Recruitment will include 50 patients undergoing colorectal surgery (25 for keyhole/laparoscopic, 25 for open procedures). Each patient will act as their own control.
To detect the fluorescence, a special fluorescent laparoscope for keyhole surgery will be utilised, and a wide-field camera will be used for open surgery.
The potential benefits of this procedure are to identify the ureters during surgery and therefore prevent inadvertent damage to them
It is hoped that near infra-red light emitting from the ureters will be detected. This will allow the surgeon to determine the anatomy of the ureters during the operation and avoid inadvertent injury.
Funding source: Nuffield Department of Surgical Sciences, University of Oxford Recruitment sites: Oxford University Hospitals NHS Trust.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
Methylene Blue
Intravenous administration of methylene blue and assessment of ureteric fluorescence intraoperatively.
Intervention: Methylene Blue
Outcomes
Primary Outcomes
To compare the change in ureter identification over time using white light versus intravenous methylene blue in each patient.
Time Frame: This will be assessed at the following time points post methylene blue administration: 0 minutes; 5 minutes; 10 minutes; 20 minutes; 30 minutes; 40 minutes; 50 minutes; 60 minutes; 70 minutes; 80 minutes; 90 minutes; 100 minutes.
Ureter identification with and without fluorescence.
Secondary Outcomes
- Fluorescence quantification following administration of methylene blue between dosing cohorts post methylene blue administration.(This will be assessed at the following time points post methylene blue administration: 0 minutes; 5 minutes; 10 minutes; 20 minutes; 30 minutes; 40 minutes; 50 minutes; 60 minutes; 70 minutes; 80 minutes; 90 minutes; 100 minutes.)