NCT05591053

Brief Summary

ActivSight™ combines an innovative form factor and proprietary software to deliver precise, objective, real-time visualization of blood flow and tissue perfusion intraoperatively for laparoscope-based surgery. A small adaptor that fits between any existing laparoscope and camera systems and a separate light source placed along any current commercial system will deliver objective real-time tissue perfusion and blood flow information intraoperatively. Primary Objective: To determine the feasibility of ActivSight™ in detecting and displaying tissue perfusion and blood flow in the conduit and foregut anastomoses in esophageal resection/reconstructive surgery. The investigators will compare the precision and accuracy among the naked eye inspection, ICG and LSCI in assessing the vascularity of the conduit.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
70

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Apr 2023

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 17, 2022

Completed
7 days until next milestone

First Posted

Study publicly available on registry

October 24, 2022

Completed
5 months until next milestone

Study Start

First participant enrolled

April 1, 2023

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2025

Completed
Last Updated

February 21, 2024

Status Verified

February 1, 2024

Enrollment Period

1.8 years

First QC Date

October 17, 2022

Last Update Submit

February 20, 2024

Conditions

Keywords

laparoscopicrobot assisted surgerygastrointestinal anastomosesesophagectomyesophageal surgerythoracic surgeryalimentary surgeryperfusionindocyanine green (ICG)laser speckle contrast imaging (LSCI)cancerminimally invasive surgery (MIS)

Outcome Measures

Primary Outcomes (10)

  • Incidence of Adverse Events in 28 days following use of ActivSight™

    To determine safety of ActivSight™ in patients undergoing esophageal surgery, as defined through clinical assessments and evaluation of use related adverse events intraoperatively and a routine follow up at 28 days following surgery. ActivSight™ will be deemed safe if no hardware (adaptor or light source)-related major (serious) adverse event is encountered in the treated patients and if less than 2 hardware-related minor adverse events are encountered. Adverse events will be summarized descriptively and tabulations on the type, severity, and relationship to application will be performed and any changes of outcomes from baseline on follow up will be examined using the nonparametric Wilcoxon rank test.

    28 days

  • Preparation time of ActivSight™.

    Rate on a scale of 1-5 (1 = Difficult to use or Unsatisfied - 5 = no training required or very satisfied): How easy was ActivSight to set up?

    1 day

  • Latency of display of ActivSight™.

    Rate on a scale of 1-5 (1 = Difficult to use or Unsatisfied - 5 = no training required or very satisfied): How specifically did ActivSight display the intended field and the target tissue of interest?

    1 day

  • Resolution and objectivity of display of ActivSight™.

    Rate on a scale of 1-5 (1 = Difficult to use or Unsatisfied - 5 = no training required or very satisfied): How was the display quality of ActivSight on the intended field and target tissue of interest?

    1 day

  • Specificity of display of ActivSight™.

    Specificity of display will serve as an outcome for feasibility. Yes/No question for surgeon: "Does the perfusion information displayed by ActivSightTM reflect the expected pattern of blood flow interruption?"

    1 day

  • Usability of ActivSightTM by surgeon, as quantified by Likert scale.

    Likert scale ratings will serve as an outcome for feasibility. Scale 1-5 question (1=strongly disagree, 2=slightly disagree, 3=neutral, 4=slightly agree, 5=strongly agree): "ActivSightTM was easy to use while operating."

    1 day

  • Support personnel satisfaction with ActivSightTM, as quantified by Likert scale.

    Likert scale ratings will serve as an outcome for feasibility. Scale 1-5 question (1=strongly disagree, 2=slightly disagree, 3=neutral, 4=slightly agree, 5=strongly agree): "ActivSightTM was easy to set up for the procedure."

    1 day

  • User feedback on utility of relative perfusion unit display versus color heatmap

    Likert scale ratings will serve as an outcome for feasibility. Scale 1-5 question (1=strongly disagree, 2=slightly disagree, 3=neutral, 4=slightly agree, 5=strongly agree):

    1 day

  • Episodes of intraoperative decision change based on display

    Yes/No if surgeons changed intraoperative planning/decisions based on ActivSight™, with additional details (what did they change and why) requested if yes.

    1 day

  • Usability of the device by surgeon and support personnel satisfaction;

    Likert scale ratings will serve as an outcome for feasibility. Scale 1-5 question (1=strongly disagree, 2=slightly disagree, 3=neutral, 4=slightly agree, 5=strongly agree):

    1 day

Secondary Outcomes (2)

  • Ability of ActivSightTM to display perfusion.

    1 day

  • Ability of ActivSightTM to display blood vessels.

    1 day

Study Arms (1)

ActivSight Group

EXPERIMENTAL

Patients undergoing esophagectomy with ActivSight (n=70)

Device: ActivSight

Interventions

Use of ActivSight in patients undergoing laparoscopic or robot assisted esophagectomy.

ActivSight Group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • All patients age \> 18 years old undergoing laparoscopic esophageal resection and reconstruction surgery; spoken command and literacy in the native language spoken at each participating center; ability to understand and follow study procedures; and having provided signed consent.
  • Diagnosis:
  • All patients with a clinical suspicion and diagnosis of benign or malignant, small or large bowel lesions requiring surgical resection.
  • Typical imaging as per standard workup findings including US, CT and/or MRI. Plain radiographs and contrast imaging may be obtained by referring physicians and are helpful for confirming the clinical diagnosis.
  • Location of pathology or resected segment:
  • \* Target lesions can be located in any fore-, mid- or hindgut segments requiring reconstruction and anastomoses.
  • Prior therapy:
  • \* Patients with prior surgery are eligible for enrollment.
  • Laboratory:
  • Hemoglobin \> 9 g/dL
  • Platelet count ≥75,000/µL (may receive transfusions)
  • Normal PT, PTT and INR \< 1.5 x ULN (including patients on prophylactic anticoagulation)
  • Renal function: Age-adjusted normal serum creatinine derived from Schwartz formula for estimating GFR by the CDC OR a creatinine clearance ≥60 mL/min/1.73 m2 for safe
  • Adequate pulmonary function: Defined as no dyspnea at rest, and a pulse oximetry \>94% on room air if there is clinical indication for determination.

You may not qualify if:

  • Patients assigned to FDA cleared ICG-based visualization are contraindicated for any chronic renal dysfunction, potential drug interaction, history of allergy to ICG or anaphylaxis, known allergy to iodides, breast-feeding or being of reproductive age with pregnancy possible and not ruled out, and pregnancy.
  • Patients currently in any investigational agents.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of Pittsburgh Medical Center - Dept of Cardiothoracic Surgery

Pittsburgh, Pennsylvania, 15213, United States

RECRUITING

West Penn Hospital / Allegheny Health Network

Pittsburgh, Pennsylvania, 15224, United States

NOT YET RECRUITING

MeSH Terms

Conditions

Esophageal NeoplasmsEsophageal DiseasesAdenocarcinoma Of EsophagusEsophageal Squamous Cell CarcinomaNeoplasms

Condition Hierarchy (Ancestors)

Gastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteHead and Neck NeoplasmsDigestive System DiseasesGastrointestinal DiseasesCarcinoma, Squamous CellCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasms, Squamous Cell

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
SINGLE GROUP
Model Details: Target enrollment for the assessment of esophageal anastomoses is a total of 70 patients powered to detect \~ 2-3 cm discordance between ICG and LSCI lines of demarcation between well vascularized and less vascularized site in the gastric conduit. Since ActivSight™ can detect the difference of \> 2 cm between perfused versus less perfused in comparison to ICG with 80 % confidence at p\<0.05 in a sample size of n = 21, the investigators estimate that the study will require an accrual of 63 patients. With potential unforeseen dropout and mortality, the investigators recruit a total of 70 patients for the proposed study.
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 17, 2022

First Posted

October 24, 2022

Study Start

April 1, 2023

Primary Completion

January 1, 2025

Study Completion

January 1, 2025

Last Updated

February 21, 2024

Record last verified: 2024-02

Locations