Peritoneal adhesion scoring through a colorectal stoma
Research type
Research Study
Full title
Investigation into the feasibility of visualising peritoneal adhesions during ileostomy repair using a laparoscopic camera.
IRAS ID
265433
Contact name
Tan Arulampalam
Contact email
Sponsor organisation
Fisher & Paykel Healthcare
Eudract number
2019-001776-11
Clinicaltrials.gov Identifier
U1111-1231-8862, Universal Trial Number
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
In order to create a working space during laparoscopic surgery, the abdomen is distended with Carbon Dioxide (CO2) gas. This pneumoperitoneum is established when CO2 is injected into the abdomen with an insufflator. CO2 used in laparoscopic surgery is room temperature and dry (0% relative humidity) when it enters the patient causing evaporation, cooling and peritoneal tissue damage. One of the potential complications linked to this drying of the peritoneum are postoperative peritoneal adhesions.
Postoperative peritoneal adhesions are fibrous connections of the peritoneum to visceral organs and remain a major concern for the patient following abdominal surgery. Intestinal obstruction, female infertility, and pain are but some of the complications that can result from adhesions. Current evidence has highlighted the need importance of regulating insufflation temperature, oxygen concentration and inflammation as a means to reduce the severity of postoperative adhesions. Recent attempts to reduce surgical adhesions or ameliorate these complications are achieved mostly through barriers to separate the denuded areas, but few options are available to the clinician to reduce the risk of adhesions without these physical or chemical solutions.
Here we propose a clinical feasibility trial to investigate the feasibility of scoring post-operative adhesions via a laparoscopic camera inserted adjacent to the ileostomy hole during reversal surgery. While not routine in during a ileostomy repair, the use of laparoscopic cameras are very routine in other abdominal surgeries carried out by Prof. Arulampalam and his team at Colchester hospital. This additional laparoscopic survey will look within the peritoneum and score adhesions that may have formed during the patient’s initial resection surgery.
Other than laparoscopic related issues (below), no additional post-operative complications are foreseen following this procedure.
REC name
London - Bromley Research Ethics Committee
REC reference
19/LO/1841
Date of REC Opinion
10 Feb 2020
REC opinion
Further Information Favourable Opinion