MedPath

Robotic Emergency General Surgery Program

Not yet recruiting
Conditions
Emergency General Surgery
Registration Number
NCT07202442
Lead Sponsor
Centre Hospitalier Universitaire de Nice
Brief Summary

Background Abdominal surgical emergencies account for 20-30% of visceral surgery procedures. However, these emergencies are responsible for more than half of the morbidity in our discipline, with a surgical site infection rate four times higher than in elective surgery, and significantly higher rates of surgical revision and conversion (PMID: 34225343 and 27016997 and 27120712). In cases where minimally invasive surgery is converted to laparotomy, patients are three times more likely to be admitted to critical care units (PMID: 39966134). Visceral surgery currently represents the largest and fastest-growing discipline in robotic surgery. Robotic management of emergency general surgery has been described in the literature for several years, particularly in the United States. Robotic surgery allows a shift from open procedures to minimally invasive techniques or simplifies complex laparoscopic procedures. Several literature reviews and meta-analyses report decreased laparotomy rates, reduced perioperative morbidity, and shorter average length of hospital stay (PMID: 38446451 and 38918109). Abdominal surgical emergencies account for 20-30% of visceral surgery procedures. However, these emergencies are responsible for more than half of the morbidity in our discipline, with a surgical site infection rate four times higher than in elective surgery, and significantly higher rates of surgical revision and conversion (PMID: 34225343 and 27016997 and 27120712). In cases where minimally invasive surgery is converted to laparotomy, patients are three times more likely to be admitted to critical care units (PMID: 39966134). Visceral surgery currently represents the largest and fastest-growing discipline in robotic surgery. Robotic management of emergency general surgery has been described in the literature for several years, particularly in the United States. Robotic surgery allows a shift from open procedures to minimally invasive techniques or simplifies complex laparoscopic procedures. Several literature reviews and meta-analyses report decreased laparotomy rates, reduced perioperative morbidity, and shorter average length of hospital stay (PMID: 38446451 and 38918109).Primary Objective:To assess the implementation of a robotic surgery program for emergency visceral procedures (proof of feasibility in our university hospital). Secondary Objectives: Reduce perioperative morbidity, Reduce the rate of laparotomy, Reduce the average length of hospital stay (LOS), Reduce postoperative admission to critical care, Reduce operative time.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Acute cholecystitis with predictors of intraoperative difficulty.
  • Bowel obstruction requiring bowel resection (in presence of CT signs of visceral compromise: poor enhancement of bowel loops, pneumoperitoneum).
  • Complicated acute diverticulitis with perforation and peritonitis.
  • Penetrating abdominal trauma with hemodynamic stability requiring surgery (e.g., bowel resection-anastomosis).
  • Right or left colectomy for other etiologies.
  • Splenectomy in hemodynamically stable or embolized patients.
Exclusion Criteria
  • Hemodynamic instability.
  • Uncomplicated acute appendicitis.
  • Acute cholecystitis without predictors of intraoperative difficulty.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Implementation of a robotic surgery program for emergency visceral proceduresPostoperative day 30

To assess the implementation of a robotic surgery program for emergency visceral procedures (proof of feasibility in our university hospital).The team will screen patients who will meet the inclusion criteria and the first score will be : were we able to purpose robotic approach fr the patient. Then if we were able to do it, and if not, the reason why (OT nurse difficulty ? technical issue ? other ?).

Secondary Outcome Measures
NameTimeMethod
Evaluating robotic general emergencies procedures (Change operative time)Postoperative day 30

In minutes, vs historical data

Evaluating robotic general emergencies procedures (Change perioperative morbidity)Postoperative day 30.

Clavien-Dindo Classification ( grade 1 to 5) vs an historical cohort

Evaluating robotic general emergencies procedures (Change the average length of hospital stay )Postoperative day 30

(LOS)-(in days, vs historical data)

Evaluating robotic general emergencies procedures (Change the rate of laparotomy)Postoperative day 30

Pourcentage vs historical data

Evaluating robotic general emergencies procedures (Change postoperative admission to critical care)Postoperative day 30

Pourcentage vs historical data

Trial Locations

Locations (1)

CHU de NICE

🇫🇷

Nice, Alpes Maritimes, France

CHU de NICE
🇫🇷Nice, Alpes Maritimes, France
Damien Massalou
Contact
04 92 03 22 63
massalou.d@chu-nice.fr

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