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Termination due to acquisition of PEAK Surgical by Medtronic
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The purpose of this clinical study is to quantify the difference in thermal injury depth at the surgical margin in breast lumpectomy specimens excised with the PlasmaBlade; to subjectively assess histopathologic sample quality metrics; to examine the role that electrosurgical artifact may play in revision lumpectomy procedures; and to compare these endpoints to the standard of care (SOC) technology.
Lumpectomy is a surgical procedure performed to remove a localized mass of breast tissue that is suspicious for malignancy. The purpose of lumpectomy is to minimize the amount of tissue removed from the breast to retain normal breast architecture while simultaneously removing all of the suspected cancerous tissue. Typically, a scalpel is used for the skin incision and a traditional electrosurgical device is used to cut away any cancerous tissue.
The PEAK PlasmaBladeâ„¢ uses pulsed radiofrequency (RF) energy and a highly-insulated handpiece design to enable precision cutting and coagulation at the point of application. The PlasmaBlade has received FDA clearance for use in plastic, general, and ear, nose, and throat (ENT) surgery, and has demonstrated a significantly reduced thermal injury profile in incised tissue compared to traditional electrosurgical devices. It is hypothesized that this benefit may improve the pathological analysis of excised breast lumps.
This single site study was granted Institutional Review Board (IRB) approval and conducted between June 2009 and January 2011. Potential subjects were screened against the inclusion and exclusion criteria of the study protocol and were then required to provide informed consent prior to enrollment. Following enrollment, subjects were prospectively randomized to the SOC or PEAK PlasmaBlade study groups and scheduled for lumpectomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PlasmaBlade | Experimental | The entirety of the lumpectomy will be performed with the PEAK PlasmaBlade, including the skin incision. |
|
| SOC | Active Comparator | The SOC consists of scalpel for the skin incision and traditional electrosurgery for the entirety of the subcutaneous dissection. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PEAK PlasmaBlade | Device | The entirety of the lumpectomy will be performed with the PEAK PlasmaBlade including the skin incision |
|
| Measure | Description | Time Frame |
|---|---|---|
| Histological Metrics: Amount of Overlying Adherent Char on Slide; Damage to Tumor Epithelium; Effect of Electrosurgical Damage on Diagnostic Quality of Lumpectomy Specimen | Overall histological quality score will be a composite of the histological metrics | Intraoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Operative Metrics: Operative Time, Estimated Blood Loss, Skin Scarring | Intraoperatively and 1-2 weeks postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Peter Naruns, MD | Midpeninsula Surgical Associates | Principal Investigator |
| Khoi Tran, MD | Palo Alto Medical Foundation | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| El Camino Surgery Center | Mountain View | California | 94040 | United States | ||
| Palo Alto Medical Foundation |
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| ID | Title | Description |
|---|---|---|
| FG000 | PlasmaBlade | The entirety of the lumpectomy will be performed with the PEAK PlasmaBlade, including the skin incision. |
| FG001 | Standard of Care (SOC) | The SOC consists of scalpel for the skin incision and traditional electrosurgery for the entirety of the subcutaneous dissection. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | PlasmaBlade | The entirety of the lumpectomy will be performed with the PEAK PlasmaBlade, including the skin incision. |
| BG001 | Standard of Care (SOC) | The SOC consists of scalpel for the skin incision and traditional electrosurgery for the entirety of the subcutaneous dissection. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | An integrity audit found that the data for this study could not be analyzed owing to unverifiable source documentation. The protocol-specified age range is used for this baseline measure. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Secondary | Operative Metrics: Operative Time, Estimated Blood Loss, Skin Scarring | An integrity audit found that the data for this study could not be analyzed owing to unverifiable source documentation. | Posted | Intraoperatively and 1-2 weeks postoperatively |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | PlasmaBlade | The entirety of the lumpectomy will be performed with the PEAK PlasmaBlade, including the skin incision. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Postoperative axillary abcess with cellulitis | Infections and infestations |
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Upon Medtronic's acquisition of PEAK surgical, a study integrity audit was undertaken. Results of the audit showed that patient's rights and safety were maintained, but the source data, including baseline demographics, were unverifiable.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Robert Swain, PhD | Medtronic Surgical Technologies | (+1-603) 294-5428 | robert.e.swain@medtronic.com |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D000084462 | Hyperthermia |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| D053685 | Laser Therapy |
| D004598 | Electrosurgery |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D055011 | Ablation Techniques |
| D013514 | Surgical Procedures, Operative |
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| Traditional Electrosurgery with scalpel | Procedure | The skin incision will be performed using a standard scalpel; the subcutaneous dissection will be performed with traditional electrosurgery using the Cut and Coagulation modes. |
|
|
| Mountain View |
| California |
| 94040 |
| United States |
| BG002 | Total | Total of all reporting groups |
| Number |
| participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|---|
| Participants |
|
| Primary | Histological Metrics: Amount of Overlying Adherent Char on Slide; Damage to Tumor Epithelium; Effect of Electrosurgical Damage on Diagnostic Quality of Lumpectomy Specimen | Overall histological quality score will be a composite of the histological metrics | An integrity audit found that the data for this study could not be analyzed owing to unverifiable source documentation. | Posted | Intraoperative |
|
|
| 1 |
| 25 |
| 0 |
| 25 |
| EG001 | Standard of Care (SOC) | The SOC consists of scalpel for the skin incision and traditional electrosurgery for the entirety of the subcutaneous dissection. | 0 | 25 | 0 | 25 |
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| D017437 |
| Skin and Connective Tissue Diseases |
| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D018882 | Heat Stress Disorders |
| D014947 | Wounds and Injuries |