A Prospective, Single-Center Investigation of the da Vinci SP® Surgical System in Anterior Mediastinal Disease

Sponsor
Chang Gung Memorial Hospital (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT05455840
Collaborator
(none)
15
1
22.2

Study Details

Study Description

Brief Summary

Endpoints (Outcome measures):

  1. Primary endpoint: Incidence of conversion rate during surgery
  • The primary performance endpoint will be assessed as the ability to successfully complete the planned mediastinal procedure with da Vinci SP System, with no conversion to open surgery, video-assisted thoracoscopic surgery (VATS), multi-port robotic surgery or approach requiring undocking of the da Vinci SP Surgical System in order to complete the planned procedure using the alternate approach. Use of additional assistant port(s) is not considered a conversion
  1. Secondary endpoints: Incidence of treatment related adverse events - The safety endpoint will be assessed as the incidence of all intra-operative and post-operative adverse events that occur through the 30-day follow up period
Condition or Disease Intervention/Treatment Phase
  • Device: Da Vinci SP surgical platform
N/A

Detailed Description

During the past several years, minimally invasive thoracic surgery has evolved from thoracoscopic approaches using 3 -4 ports to a single incision video-assisted thoracoscopic surgery (VATS) techniques. Recently, the experience acquired with the uniportal VATS technique through the intercostal space has allowed the development of a uniportal VATS subxiphoid or subcostal approach for anterior mediastinal tumor resections. The advantage of using a subxiphoid or subcostal entry is to reduce pain by avoiding possible trauma of intercostal nerves caused by thoracic incisions. However, the longer distance from the subxiphoid or subcostal incision to the anterior mediastinal area makes this approach more difficult to perform extended thymothymectomy. During this same period of evolution into uniportal VATS surgery, robotic thoracic surgery has gained popularity as an alternative to traditional VATS. The advantages of robotics are the ability to perform surgery more precisely with articulated or wristed instruments, motion scaling, and tremor filtration, as well as improved visualization thanks to 3D high-definition video. However, currently 4 -5 incisions are still necessary to perform anatomic robotic resections.Recently, there has been a convergence of these two trends-uniportal surgery and robotic-assisted surgery-and has resulted in a single port robotic system, the da Vinci SP by Intuitive Surgical Cooperation. For this new platform, investigators plan to practice in extended thymothymectomy

Study Design

Study Type:
Interventional
Anticipated Enrollment :
15 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
thymothmectomy or extended thymectomy through Da Vinci SP platformthymothmectomy or extended thymectomy through Da Vinci SP platform
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Prospective, Single-Center Investigation of the da Vinci SP® Surgical System in Anterior Mediastinal Disease
Anticipated Study Start Date :
Jul 25, 2022
Anticipated Primary Completion Date :
Jul 24, 2023
Anticipated Study Completion Date :
Jun 1, 2024

Arms and Interventions

Arm Intervention/Treatment
Experimental: Intervention

Patients with qualified criteria will be enrolled in this study

Device: Da Vinci SP surgical platform
using Da Vinci SP platform in thymothymectomy or extended thymectomy

Outcome Measures

Primary Outcome Measures

  1. Incidence of conversion rate [During Surgery]

    The primary performance endpoint will be assessed as the ability to successfully complete the planned procedure with da Vinci SP System, with no conversion to thoracoscopic, multi-port robotic, or open surgery.

Secondary Outcome Measures

  1. Incidence of Treatment-Emergent Adverse Events [One year]

    The safety endpoint will be assessed as the incidence of all intra-operative and post-operative adverse events that occur through the 30-day follow up period. Rceord the Incidence of Treatment-Emergent Adverse Events in our recording form

Eligibility Criteria

Criteria

Ages Eligible for Study:
20 Years to 75 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No

Inclusion criteria

  1. Age >20 and <75 years-old

  2. Willing and able to provide informed consent

  3. ASA≤ 3

  4. The subject fulfills one or both of the following criteria:

  • Diagnosis of myasthenia gravis

  • Masaoka stage I or II thymoma; thymic mass ≤ 5 cm diameter

  1. Class I-IV Myasthenia gravis according to the Myasthenia Gravis Foundation of America Scientific Session (MGFA)

Exclusion criteria. Myasthenia gravis or thymoma patients with

  1. Congestive heart failure (NHYA > II)

  2. Arrhythmia required medication control

  3. Subjects with a known bleeding or clotting disorder

  4. Subjects actively receiving therapeutic dose anticoagulation or anti-platelet medications at the time of operation

  5. Subjects under immunomodulatory within 30 days prior to the planned surgery

  6. Previous ipsilateral thoracic surgery or sternotomy

  7. Uncontrolled illness 6 months prior to planned surgical procedure including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

  8. Previous neoadjuvant medical and/or radiation therapy

  9. Subject has a contraindication for general anesthesia or surgery

  10. Uncontrolled myasthenia gravis symptoms at the time of scheduled surgery

  11. Confirmed thymic carcinoma

  12. Patients who are not suitable for performing endoscopic surgery.

  13. Myasthenia gravis patients with positive serum MuSK antibody. -

Contacts and Locations

Locations

No locations specified.

Sponsors and Collaborators

  • Chang Gung Memorial Hospital

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Chang Gung Memorial Hospital
ClinicalTrials.gov Identifier:
NCT05455840
Other Study ID Numbers:
  • 202101422A0
First Posted:
Jul 13, 2022
Last Update Posted:
Jul 13, 2022
Last Verified:
May 1, 2022
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Product Manufactured in and Exported from the U.S.:
Yes
Keywords provided by Chang Gung Memorial Hospital
Additional relevant MeSH terms:

Study Results

No Results Posted as of Jul 13, 2022