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Evaluate early postoperative complications after surgery in Trendelenburg position with increased intraabdominal pressure (surgery with pneumoperitoneum). Evaluate the relationship between hemodynamic and metabolic changes on perioperative outcome.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laparoscopic Surgery | Procedure | Laparoscopic surgery (with controlled pneumoperitoneum) in the Trendelenburg position |
| Measure | Description | Time Frame |
|---|---|---|
| Perioperative change in urine NGAL | Measurement of the concentration of neutrophil gelatinase-associated lipocalin (as an early marker of kidney injury) in a urine sample taken from a Foley catheter | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Acute Kidney Injury | According to the KDIGO acute renal injury stage | 2 hours after completion of surgery; 1 day after the procedure; 3 days after the procedure. |
| Perioperative change in serum NGAL | Measurement of the concentration of neutrophil gelatinase-associated lipocalin (as an early marker of kidney injury) in a blood sample | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in serum concentration of Cannabidiol | Measurement of the concentration of cannabidiol (as an early marker of kidney injury) in a blood sample | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery and 2h hours after completion of surgery |
| Perioperatitve change in urine concentration of Cannabidiol | Measurement of the concentration of cannabidiol (as an early marker of kidney injury) in a urine sample taken from a Foley catheter | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in TBW | Perioperative change in the bioimpedence-based measurement of Total Body Water (TBW) |
| Measure | Description | Time Frame |
|---|---|---|
| Delirium | As assessed by CAM-ICU | Within 7 days after surgery |
| CVA / TIA | New diagnosis of cerebrovascular accident or transient ischemic attack |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients who undergo elective laparoscopic surgery in the Hadassah Ein-Kerem Medical Center
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Reuven Pizov, MD | Contact | +9720506265542 | pizovr@hadassah.org.il |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hadassah Medical Center | Recruiting | Jerusalem | Yerushalaim | Israel |
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| ID | Term |
|---|---|
| D011027 | Pneumoperitoneum |
| ID | Term |
|---|---|
| D010532 | Peritoneal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D010535 | Laparoscopy |
| ID | Term |
|---|---|
| D004724 | Endoscopy |
| D003949 | Diagnostic Techniques, Surgical |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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Blood and urine samples
| Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in ECW | Perioperative change in the bioimpedence-based measurement of Extracellular Water (ECW) | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in serum pH | As measured by arterial blood gas | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in serum BE | Perioperatitve change in serum Base Excess (BE) As measured by arterial blood gas | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in serum lactate concentration | Perioperatitve change in serum lactate concentration as measured by arterial blood gas | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Perioperatitve change in serum syndecan-1 concentration | Measured by ELISA | Baseline (after anesthesia induction but before beginning of surgery) and 2h hours after completion of surgery |
| Within 30 days after surgery |
| Myocardial Ischemia | New myocardial ischemia, as diagnosed by ecg or serum troponin | During hospital stay, within 30 days after surgery |
| Arrhythmia | New clinically significant arrhythmia | During hospital stay, within 30 days after surgery |
| Atelectasis | New atelectasis | During hospital stay, within 30 days after surgery |
| Pneumonia | According to CDC criteria | During hospital stay, within 30 days after surgery |
| ARDS | New Acute Respiratory Distress Syndrome (ARDS) according to Berlin criteria | During hospital stay, within 30 days after surgery |
| D019060 | Minimally Invasive Surgical Procedures |
| D013514 | Surgical Procedures, Operative |