UMIN-ICDS Clinical Trial

Unique ID issued by UMIN UMIN000052881
Receipt number R000060161
Scientific Title Intraoperative intraocular pressure changes in robot-assisted laparoscopic total prostatectomy
Date of disclosure of the study information 2023/12/01
Last modified on 2023/11/22 13:40:46

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Basic information

Public title

Intraoperative intraocular pressure changes in robot-assisted laparoscopic total prostatectomy

Acronym

Intraoperative intraocular pressure changes in robot-assisted laparoscopic total prostatectomy

Scientific Title

Intraoperative intraocular pressure changes in robot-assisted laparoscopic total prostatectomy

Scientific Title:Acronym

Intraoperative intraocular pressure changes in robot-assisted laparoscopic total prostatectomy

Region

Japan


Condition

Condition

prostate cancer scheduled to have Robotic-assisted laparoscopic total prostatectomy

Classification by specialty

Urology

Classification by malignancy

Malignancy

Genomic information

NO


Objectives

Narrative objectives1

There are reports of visual impairment after da Vinci surgery. The main cause of visual failuare is suspected that increased intraocular pressure (IOP) due to prolonged head down position.
In this study, we performed preoperative ophthalmologic examination (visual acuity, intraocular pressure, corner angle widening, etc.). In operative day, patients with no abnormalities at preoperative ophthalmologic examination were estimated IOP during surgery, and post operative day.
To determine the effect of low head position and pneumoperitoneum pressure on IOP. Also, find out what risk factors increasing IOP.
These investigations will determine the safety of da Vinci surgery.

Basic objectives2

Safety

Basic objectives -Others


Trial characteristics_1

Others

Trial characteristics_2

Others

Developmental phase

Not applicable


Assessment

Primary outcomes

Preoperative ophthalmologic examination (performed by an ophthalmologist in an ophthalmology outpatient clinic): measurement of intraocular pressure with Tonopen(Non-contact tonometer).
Ophthalmologist examine for abnormalities in IOP, corner angles, fundus findings.

Key secondary outcomes

a) 1 Visual acuity test (corrected visual acuity) 2 Slit-lamp microscopy (presence of cataracts, corner angle widening, anterior chamber depth, pupil diameter) 3 Fundus examination.
b) 1 Anaesthetic method, amount of phenirephrine and ephedrine, and atropine 2Operative technique, time of head down position, insufflation time, operative time, amount of blood loss and infusion volume


Base

Study type

Interventional


Study design

Basic design

Single arm

Randomization

Non-randomized

Randomization unit


Blinding

Open -no one is blinded

Control

Self control

Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms

1

Purpose of intervention

Prevention

Type of intervention

Device,equipment

Interventions/Control_1

usually, we do not estimate IOP during da vinch surgery unlike this study because keratitis is rarely caused by using Tonopen.
As a precaution, antibiotic eye drops were used before measurements and the cover on the tip of the tonopen was changed at each measurement.

Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

30 years-old <

Age-upper limit

83 years-old >=

Gender

Male

Key inclusion criteria

Adult men with ASA I or II undergoing da Vinci surgery and have given consent for the study.

Key exclusion criteria

Patients with corneal disease, glaucoma, diabetic retinopathy (Fukuda classification A1 or higher) and other conditions deemed inappropriate at the preoperative consultation.
Patients with systemic complications above ASA III

Target sample size

40


Research contact person

Name of lead principal investigator

1st name Takenami
Middle name
Last name Tamie

Organization

Kitasato University School of Medicine

Division name

Anesthesiology

Zip code

252 0375

Address

Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara city, Minamiku, Kanagawa, Japan

TEL

040-778-8111

Email

takenami@med.kitasato-u.ac.jp


Public contact

Name of contact person

1st name Takenami
Middle name
Last name Tamie

Organization

Kitasato University School of Medicine

Division name

Anesthesiology

Zip code

252 0375

Address

Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara city, Minamiku, Kanagawa, Japan

TEL

040-778-8111

Homepage URL


Email

takenami@med.kitasato-u.ac.jp


Sponsor or person

Institute

Takenami Tamie
Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara city, Minamiku, Kanagawa, Japan
Department of Anesthesiology

Institute

Department

Personal name



Funding Source

Organization

none

Organization

Division

Category of Funding Organization

Other

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Ethics Revyew Office, Kitasato University School of Medicine

Address

Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara city, Minamiku, Kanagawa, Japan

Tel

042 778 8111

Email

rinnrib@med.kitasato-u.ac.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2023 Year 12 Month 01 Day


Related information

URL releasing protocol

This stusy is not available to the public

Publication of results

Unpublished


Result

URL related to results and publications

This stusy is not available to the public

Number of participants that the trial has enrolled

35

Results

LARP is performed by a transperitoneal approach(I; head-down angle 25) and a retroperitoneal approach(R; head-down angle 5).
*l approach has significantly less effect on IOP.
*The influence of pneumoperitoneum pressure on IOP is not greater than that of head down position.
*We investigated risk factors for increased IOP.
As a results, the younger the age, and the heavier the weight are the risk factor for increasing the intraocular pressure only in the I approach group

Results date posted

2023 Year 11 Month 21 Day

Results Delayed


Results Delay Reason

Takenami, who was in charge of the research, suffered cerebral infarctions in December 2015 and 2018 and underwent STA-MCA bypass surgery, resulting in a long research period.

Date of the first journal publication of results


Baseline Characteristics

Recently, visual impairment after prone surgery has been reported. The cause is suspected to be increased intraocular pressure.
Similar reports have been made regarding da Vinci surgery, and increased intraocular pressure due to a low head position is suspected to be the cause.
However, there are few reports on measuring intraocular pressure during da Vinci surgery.
Therefore, we measured intraocular pressure in two kind of da Vinci surgeries (25 degree of transperitoneal approach vs. 15degree of retroperitoneal approach) with different head-lowing angles.

Participant flow

Patients scheduled for da Vinci surgery on Wednesday will be admitted to the hospital on Tuesday.
After the patient is admitted around 10 a.m. on Tuesday, Dr. Takenami conduct a preoperative consultation to obtain consent for the study from adult patients with ASAI or II.
If consent is obtained from patient, we contact the ophthalmology outpatient clinic and have them receive the ophthalmology outpatient clinic.
The presence or absence of any problems during the ophthalmology visit will be checked using medical records, and for patients with no ophthalmological problems, intraocular pressure will be measured during surgery on the following Wednesday.

Adverse events

nothing

Outcome measures

*Preoperative ophthalmological examination
Visual acuity, angle, intraocular pressure, fundus examination.

*Intraoperative examination
Intraocular pressure measurement is performed with a Tonopen. we are sure to apply antibiotic eye drops before and after measuring intraocular pressure.
Measurement points: At the start of surgery, at the start of pneumoperitoneum, after the start of head low position, 1 hour after the start of head low position, 2 hours after the start, at the time of ureter resection, just before the end of low head position

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2015 Year 04 Month 15 Day

Date of IRB

2016 Year 03 Month 25 Day

Anticipated trial start date

2016 Year 05 Month 11 Day

Last follow-up date

2019 Year 11 Month 20 Day

Date of closure to data entry

2019 Year 12 Month 16 Day

Date trial data considered complete

2020 Year 01 Month 13 Day

Date analysis concluded

2020 Year 02 Month 18 Day


Other

Other related information



Management information

Registered date

2023 Year 11 Month 23 Day

Last modified on

2023 Year 11 Month 22 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000060161


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name