Prostate Cancer Clinical Trial

The Impact of Low Pressure Pneumo in RARP

Summary

The purpose of this study is to evaluate clinical significance of low pressure pneumoperitoneum during robotically assisted radical prostatectomy (RARP).

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Full Description

Laparoscopic and robotic surgery has revolutionized post-operative outcomes across surgical specialties. However, the use of pneumoperitoneum comes with known risks given the change in physiological parameters that accompany its utilization. The effects of increased intra-abdominal pressure on cardiopulmonary function has been well documented. Increased pressure on the large vessels may lead to decreased cardiac output and thereby decreased blood flow to various organ systems and cause irreversible damage. Some studies have advocated lower pressures to further optimize cardiopulmonary parameters. McDougall, et. al, for instance, demonstrated a significant reduction in oliguria when pressures of 10mm Hg were used. The purpose of this study is to evaluate the effect of using lower pressure pneumoperitoneum in the abdominal cavity during RARP. The investigators hypothesize that low pressure pneumoperitoneum has a multitude of clinical benefits due to improved physiologic parameters including a reduction in the occurrence of post-operative ileus, reduced need for narcotics post operatively, and a decrease in cardiopulmonary complications.

The study is a prospective randomized blinded cohort study. Patients who meet eligibility criteria will be randomly assigned to undergo RARP at a pneumoperitoneum pressure of 12mm Hg or 8mm Hg. This will be done by computer generated randomization protocol. Surgeon and patients will be blinded to the pneumoperitoneum pressure used. A cover will be placed over the AirSeal™ system so that the surgeon(s) are not able to visualize the pneumoperitoneum used during the procedure. The remainder of the procedure will be carried out based on current standard of care.

All patients will be admitted post operatively and the same standardized order-set in EPIC EHR will be used for all patients in order to control for other factors, such as opioid use, to control for confounders.

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Eligibility Criteria

Inclusion Criteria:

Male 40 years of age or older
Diagnosis of prostate cancer
Have been evaluated to be fit for proposed surgery
Patients able to consent

Exclusion Criteria:

Patients unable to consent (cognitively impaired)
Non-English speaking

Study is for people with:

Prostate Cancer

Estimated Enrollment:

222

Study ID:

NCT03370016

Recruitment Status:

Completed

Sponsor:

Metro Health, Michigan

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There is 1 Location for this study

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Metro Health
Wyoming Michigan, 49519, United States

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Study is for people with:

Prostate Cancer

Estimated Enrollment:

222

Study ID:

NCT03370016

Recruitment Status:

Completed

Sponsor:


Metro Health, Michigan

How clear is this clinincal trial information?

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