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Trial registered on ANZCTR
Registration number
ACTRN12618000818235
Ethics application status
Approved
Date submitted
9/05/2018
Date registered
11/05/2018
Date last updated
8/08/2019
Date data sharing statement initially provided
8/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Warm Humidified Insufflation on Lens Fogging during Laparoscopic Cholecystectomy. A Single centre, superiority, blinded randomised controlled trial.
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Scientific title
Effect of Warm Humidified Insufflation on Lens Fogging during Laparoscopic Cholecystectomy. A Single centre, superiority, blinded randomised controlled trial.
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Secondary ID [1]
294576
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None
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Universal Trial Number (UTN)
U1111-1203-2641
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cholecystitis
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Condition category
Condition code
Surgery
306809
306809
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0
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Surgical techniques
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Oral and Gastrointestinal
306840
306840
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Eligible patients undergoing elective laparoscopic cholecystectomy at Auckland District Health Board will be approached to take part in the study. If the patient consents they will be randomised to either receive warmed and humidified CO2 insufflation using the Humigard device or standard CO2 insufflation during the procedure.
Intervention arm – Patients will receive humidified insufflation. This will be given by commercially available gas insufflation device. Connected to an insufflator, Humigard warms and humidifies the CO2 to 37oC and 100% relative humidity.
The images taken by the laparoscopic camera will be assessed during the procedure and the number of fogging events will be recorded by a research nurse. The images will be recorded and after the procedure they will be saved onto an external hard drive. Three experienced surgeons who are blinded to the treatment allocation will score the images and assess any fogging events.
There is no follow up for this study.
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Intervention code [1]
301137
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Treatment: Surgery
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Intervention code [2]
301158
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Treatment: Devices
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Comparator / control treatment
Control arm – Patients will receive the same treatment for their cholecystitis and the camera will not be set up to receive Humigard.
The images taken by the laparoscope will be assessed during the procedure and the number of fogging events will be recorded by a research nurse. The images will be recorded and after the procedure they will be saved onto an external hard drive. Three experienced surgeons who are blinded to the treatment allocation will score the images and assess any fogging events.
A sub-set of de-identified, pooled video data will be shared with the engineering department of the sponsor, Fisher & Paykel Healthcare, to enable creation of an algorithm that is needed to analyse all caputured videos at completion of the study.
There is no follow up for this study.
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Control group
Active
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Outcomes
Primary outcome [1]
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Number of fogging events recorded onto the case report form by a research nurse at the time of surgery.
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Assessment method [1]
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Timepoint [1]
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Throughout the surgical procedure by a research nurse and retrospectively based on review of laparoscopic recordings by a consultant.
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Primary outcome [2]
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Duration of fogging measured by a research nurse using a stopwatch.
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Assessment method [2]
305811
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Timepoint [2]
305811
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Throughout the surgical procedure by a research nurse and retrospectively based on review of laparoscopic recordings by a consultant.
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Secondary outcome [1]
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The combined subjective effort fogging had on the procedure as reported by the operating surgeon, assistant surgeon and scrub nurse. This will be measured using a Likert-like scale.
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Assessment method [1]
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Timepoint [1]
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Within one hour of completion of surgery.
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Eligibility
Key inclusion criteria
1. Scheduled to undergo laparoscopic cholecystectomy
2. Able to give informed consent
3. Male or female 18 years of age or older.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Participant is pregnant
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients are randomised using random numbers obtained by a computer-based random number generator. Concealment will be achieved by the use of opaque envelopes opened at surgery by a third party.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size calculation - To calculate the number of patients to be include in the trial the standard power parameter of 0.8 and a test level of 0.05 will be used. A recent study scored lens fogging using a scientific model which evaluated fogging on a scales from 1 to 4 and measured differences with a SD of 1. To account for possible increased variation in patients we increased the SD to 1.5, Thus, we used the SD value of 1.5, and a mean separation of one on the ordinal scale to separate the groups for substantive significance and to estimate a samples size. This generated a required sample size of 37 per arm, totaling 74 patients. Allowing for a drop out rate of 10% per group the numbers should be expanded to 61 in each arm or 122 in total.
Statistical analyses - Statistical difference between the two groups will be sought using independent sample t-tests for mean difference and Pearson’s chi-square tests for proportional differences. Odds ratios for effect size to be calculated along with confidence intervals. An alpha level of 0.05 to be used for all statistical tests. Analyses of effect of surgeon to be compared using independent sample t-tests and Cohen’s effect size. For demographic variables, an alpha test level of 0.05 under standard assumptions. Multivariable logistic regression for factors such as surgeon experience, operating centre etc. Kappa tests for reviewer agreement.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
18/06/2018
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Actual
8/06/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
122
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Accrual to date
50
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Final
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Recruitment outside Australia
Country [1]
10386
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New Zealand
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State/province [1]
10386
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Auckland
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Funding & Sponsors
Funding source category [1]
299193
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Commercial sector/Industry
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Name [1]
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Fisher and Paykel Healthcare
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Address [1]
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15 Maurice Paykel Place
East Tamaki
Auckland
2013
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Country [1]
299193
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New Zealand
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Primary sponsor type
Commercial sector/Industry
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Name
Fisher and Paykel Healthcare
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Address
15 Maurice Paykel Place
East Tamaki
Auckland
2013
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
298717
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Country [1]
298717
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300118
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
300118
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Ministry of Health 133 Molesworth Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
300118
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New Zealand
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Date submitted for ethics approval [1]
300118
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26/03/2018
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Approval date [1]
300118
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14/05/2018
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Ethics approval number [1]
300118
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18/STH/71
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Summary
Brief summary
This study is a medical device study on the effect of warm humidified carbon dioxide on optical clarity in laparoscopic cholecystectomy surgery. The medical device being used is called HumiGard and is approved for use in humans and is in routine medical use in several countries. It is manufactured by Fisher and Paykel Healthcare Ltd. Fisher and Paykel Healthcare (referred to as ‘FPH’) is a New Zealand owned medical device company and is the sponsor of this trial. Loss of optical clarity during laparoscopic surgery remains a major concern for surgeons. Clear vision in surgery is important not only for safety by preventing accidental injury, but also to improve precision and reduce operative time. The condensation that leads to “fogging” occurs when the temperature of the camera lens is at or below the temperature of the air surrounding the object and this study aims at investigating whether a new surgical humidifier can reduce lens fogging by warming and humidifying the carbon dioxide gas used during laparoscopic cholecystectomies. Participants undergoing laparoscopic cholecystectomy surgery at Auckland Hospital or Greenlane Hospital who meet the inclusion and exclusion criteria will be offered the opportunity to participate in the pilot study. To measure the number of fogging events that occur during a routine procedure, the video feed of the laparoscopic camera will be recorded and analysed post-operatively. This camera and its recordings are nearly entirely internal and so there will be no way to identity participants from the video. In addition to the laparoscopic camera, a camera will be placed directly about the external surgical area as to capture all events that occur outside of the abdomen (not recorded by the laparoscopic camera). During surgery, investigators or a research nurse will also take record of other measurements that will be monitored as part of standard of care. The measurements will include data such as core body temperature and the length of the procedure. Video/image analysis of laparoscopic camera will be done at a later time point by medical professionals.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof John Windsor
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Address
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Building 599, level 12
ACH Support Building
Park Road
Grafton
Auckland 1142
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Country
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New Zealand
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Phone
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+64 9 373 7599
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Fax
82622
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Email
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[email protected]
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Contact person for public queries
Name
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Sheryl Fenwick
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Address
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Building 599, level 12
ACH Support Building
Park Road
Grafton
Auckland 1142
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Country
82623
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New Zealand
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Phone
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+64 9 923 1908
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Fax
82623
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Email
82623
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[email protected]
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Contact person for scientific queries
Name
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Lotte van den Heuij
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Address
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Fisher and Paykel Healthcare
15 Maurice Paykel Place
East Tamaki
Auckland
2013
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Country
82624
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New Zealand
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Phone
82624
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+64 9 574 0123
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Fax
82624
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Email
82624
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
3512
Clinical study report
This will be decided upon completion of the study.
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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