Small Intestine Length
Conditions
Keywords
Small bowel Length, reconstructed 3D CT scan, Revisions bariatric Surgery
Brief summary
Measuring bowel length during hypo-absorptive surgeries like Roux-en-Y gastric bypass (RYGB) and Single Anastomosis Duodeno-ileal Sleeve (SADI-s) is controversial and usually abandoned due to the high risk of intestinal injury. However, some surgeons, especially in revisional surgery, prefer to count the whole bowel length to avoid leaving very short segments and severe malnutrition afterwards. 3D reconstructed CT scan can be useful in such conditions, avoiding the risk of intestinal injury, but accurate measures might be doubtful.
Interventions
DIAGNOSTIC_TESTCT
CT measurment of small bowel
PROCEDUREMeasuring the small instestine length using pre-marked laparoscopic graspers
Intra-operatively, the surgeon will assess the length of the small intestine using a 5-cm marked laparoscopic graspers to accurately assess the whole small intestine length.
Sponsors
Kasr El Aini Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Investigator)
Masking description
the investigator- the surgeon- will not be aware of the pre-operative measurements found in the CT scan, not to be biased in measuring.
Intervention model description
This is a prospective cross-sectional analytic study designed to compare two methods of small bowel length measurement: preoperative 3D CT volumetry and intraoperative laparoscopic measurement using pre-marked graspers. The study will include adult patients undergoing revisional bariatric surgeries at Kasr AlAiny Hospitals. All participants will undergo preoperative imaging and intraoperative measurements, with results analyzed to determine the accuracy and correlation between the two methods.
Eligibility
Sex/Gender
ALL
Age
16 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients who are candidates for revisional bariatric surgery * Patients consenting to participate in the study.
Exclusion criteria
* Patients with severe adhesions where measuring the small bowel may expose them to unnecessary injuries. * Patients refusing to participate in the study. * Patient refusing CT scan to be done pre-operatively.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accurate small bowel length | about 6 months | the aim of the study to assess if the CT scan with 3D reconstruction will give accurate measures for the bowel length compared to the marked graspers used in laparoscopic surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operative time | intraoperative | measuring the whole bowel length may increase the operative time according to the skills of the surgeon, the presence of adhesions, and short mesentery. |
| Intestinal Injury | up to 6 months | counting the whole bowel length is a tedious procedure, especially in patients with obesity, where the mesentery is dense and may cause injury to the bowel. In this study, we will assess the incidence of intestinal injury of the small bowel, detected intra-operatively or post-operatively. |
Countries
Egypt
Contacts
Primary ContactAhmed Mohammed Abdelsalam, MD, MRCS
Outcome results
None listed