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GATT-Patch Versus SURGICEL® Original in Minimally Invasive Liver and Gallbladder Surgery

Primary Purpose

Intraoperative Bleeding, Liver Diseases, Gallbladder Diseases

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
GATT-Patch
SURGICEL® Original
Sponsored by
GATT Technologies BV
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intraoperative Bleeding focused on measuring Hemostatic patch, GATT-Patch, SURGICEL® Original, Liver surgery, Gallbladder surgery, Hemostasis

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Subject is scheduled to undergo elective minimally invasive (robotic or laparoscopic) surgery on the liver, including cholecystectomy Subject is willing and able to give written informed consent for the clinical investigation participation Subjects is 22 years of age or older at the time of enrollment; and Subject has been informed of the nature of the clinical investigation. A subject must meet all of the following intra-operative inclusion criteria to be enrolled into the clinical investigation: Subject undergoes a fully minimally invasive surgical approach without the use of a hand port at the time of randomization and application of the patch; Subject in whom the Investigator is able to identify a target bleeding site at the liver resection plane for which any applicable conventional means for hemostasis (e.g. suture, ligature or cautery) are ineffective or impractical, and the choice is made to use a hemostatic agent to stop the bleeding Pressure on the surface of the hemostatic agent can be applied with the minimally invasive instruments to achieve hemostasis Subject has a target bleeding site with a SBSS of 1, 2, or 3 (e.g. reflecting minimal, mild or moderate bleeding severities) Exclusion Criteria: The target bleeding site is from a large defect in an artery or vein that requires vascular reconstruction with maintenance of vessel patency Subject is scheduled to undergo surgery on organs other than the liver and its associated biliary and vascular system Subject is scheduled to undergo a staged liver surgery procedure (e.g., Associating Liver Partition and Portal vein ligation for Staged hepatectomy [ALPPS]) Subject is taking multiple antithrombotic therapies in therapeutic dosage up to the time of surgery, but allowing exclusive use of acetylsalicylic acid Subject has platelet count <100 x 109/L, an activated partial thrombin time of >100s, or international normalized ratio >2.5 Subject has a total bilirubin level of ≥2.5 mg/dl Subject is pregnant, planning on becoming pregnant or actively breastfeeding during the 3-month follow-up period Subject has a known hypersensitivity to brilliant blue (FD&C Blue #1), porcine gelatin Subject who has religious objections to receiving products containing porcine Subject has an active or suspected infection at the bleeding site Subject in whom the investigational device will be used at the site of a synthetic graft or patch implant Subject has a life expectancy of less than 3 months Subject has a documented severe congenital or acquired immunodeficiency Subject has had or has planned to receive any organ transplantation Subject undergoes surgery with the indication of being a living liver donor Subject is currently participating or has participated in another clinical investigation within the past 30 days that may affect the endpoints of the study, such as trials related to the surgical procedure and anti-coagulation Subject is not appropriate for inclusion in the clinical investigation, per the medical opinion of the Investigator Subject has any incidental (pre- and peri-operative) findings deemed by the Investigator to potentially jeopardize the safety or welfare of the subject

Sites / Locations

  • University of Southern CaliforniaRecruiting
  • Washington University
  • Weill-Cornell
  • Atrium Health
  • Intermountain Healthcare

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

GATT-Patch

SURGICEL® Original

Arm Description

Hemostatic Patch

Hemostatic Patch

Outcomes

Primary Outcome Measures

Rate of hemostasis within 7 minutes from introduction of the first (piece of) patch through the trocar without rebleeding at the 10-minute time point from initiating pressure on the entire surface of the hemostatic agent
SBSS 0

Secondary Outcome Measures

Median time in seconds from introducing the hemostatic agent through the trocar and achieving hemostasis
SBSS 0
Median time in seconds from introducing the hemostatic agent through the trocar to initiating pressure on the entire surface of the agent
SBSS 0
Median time in seconds to hemostasis from initiating pressure on the entire surface of the agent
SBSS 0
Percentage of hemostasis from initiating pressure on the entire surface of the agent at 30, 60, 120, 180, 240, 300, 360, 420, 480, 540 and 600 seconds
SBSS 0-5
Kaplan-Meier estimated distribution of time to hemostasis from initiating pressure on the entire surface of the agent
SBSS 0
Treatment failure, defined as no hemostasis with the agent at 10 minutes from initiating pressure on the entire surface of the agent
SBSS 1-5 at the 10 minute timepoint
Rebleeding after the 10-minute time point from initiating pressure on the entire surface of the agent but before subject wound closure
SBSS 1-5 after initially SBSS 0
Number of times an additional (piece of) hemostatic agent needs to be used to achieve hemostasis
SBSS 1-5

Full Information

First Posted
May 19, 2023
Last Updated
October 16, 2023
Sponsor
GATT Technologies BV
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1. Study Identification

Unique Protocol Identification Number
NCT05900037
Brief Title
GATT-Patch Versus SURGICEL® Original in Minimally Invasive Liver and Gallbladder Surgery
Official Title
A Prospective, Multicenter, Randomized Clinical Investigation Evaluating GATT-Patch for Hemostasis During Minimally Invasive Liver and Gallbladder Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 6, 2023 (Actual)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
September 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GATT Technologies BV

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a pre-market, prospective, randomized (1:1), multicenter, pivotal clinical investigation. The purpose of this investigation is to determine the clinical performance of GATT-Patch as compared with SURGICEL® Original for the management of minimal, mild, or moderate bleeding during minimally invasive liver and gallbladder surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intraoperative Bleeding, Liver Diseases, Gallbladder Diseases, Hemorrhage, Surgical
Keywords
Hemostatic patch, GATT-Patch, SURGICEL® Original, Liver surgery, Gallbladder surgery, Hemostasis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Randomization 1:1
Masking
Participant
Masking Description
Patients will be blinded to randomized treatment and treatment used.
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GATT-Patch
Arm Type
Experimental
Arm Description
Hemostatic Patch
Arm Title
SURGICEL® Original
Arm Type
Active Comparator
Arm Description
Hemostatic Patch
Intervention Type
Device
Intervention Name(s)
GATT-Patch
Intervention Description
GATT-Patch is a sterile, flexible and resorbable hemostatic sealing patch. It presents as a blue, soft, flexible, porcine gelatin fiber-based carrier impregnated with an NHS-POx / NU-POx granulate. GATT-Patch measures 10 cm long by 5 cm wide. GATT-Patch is active and can be applied on both sides. Blue color is an aid to visualize GATT-Patch when applied onto a bleeding location. GATT-Patch is indicated for use as an adjunct to hemostasis in surgery for minimal, mild or moderate bleeding sites when control of bleeding by standard surgical techniques (such as suture, ligature or cautery) is ineffective or impractical. GATT-Patch is intended to be used for management of hemorrhage during surgeries on the liver.
Intervention Type
Device
Intervention Name(s)
SURGICEL® Original
Other Intervention Name(s)
Surgicel Absorbable Hemostat
Intervention Description
SURGICEL® Absorbable Hemostat (oxidized regenerated cellulose) is indicated for use in surgical procedures to assist in the control of capillary, venous and small arterial hemorrhage when ligation or other conventional methods of control are impractical or ineffective.
Primary Outcome Measure Information:
Title
Rate of hemostasis within 7 minutes from introduction of the first (piece of) patch through the trocar without rebleeding at the 10-minute time point from initiating pressure on the entire surface of the hemostatic agent
Description
SBSS 0
Time Frame
During surgical procedure
Secondary Outcome Measure Information:
Title
Median time in seconds from introducing the hemostatic agent through the trocar and achieving hemostasis
Description
SBSS 0
Time Frame
During surgical procedure
Title
Median time in seconds from introducing the hemostatic agent through the trocar to initiating pressure on the entire surface of the agent
Description
SBSS 0
Time Frame
During surgical procedure
Title
Median time in seconds to hemostasis from initiating pressure on the entire surface of the agent
Description
SBSS 0
Time Frame
During surgical procedure
Title
Percentage of hemostasis from initiating pressure on the entire surface of the agent at 30, 60, 120, 180, 240, 300, 360, 420, 480, 540 and 600 seconds
Description
SBSS 0-5
Time Frame
During surgical procedure
Title
Kaplan-Meier estimated distribution of time to hemostasis from initiating pressure on the entire surface of the agent
Description
SBSS 0
Time Frame
During surgical procedure
Title
Treatment failure, defined as no hemostasis with the agent at 10 minutes from initiating pressure on the entire surface of the agent
Description
SBSS 1-5 at the 10 minute timepoint
Time Frame
During surgical procedure
Title
Rebleeding after the 10-minute time point from initiating pressure on the entire surface of the agent but before subject wound closure
Description
SBSS 1-5 after initially SBSS 0
Time Frame
During surgical procedure
Title
Number of times an additional (piece of) hemostatic agent needs to be used to achieve hemostasis
Description
SBSS 1-5
Time Frame
During surgical procedure
Other Pre-specified Outcome Measures:
Title
Conversion from minimally invasive to open surgery, and reasons for conversion
Description
SBSS 1-5
Time Frame
During surgical procedure
Title
Procedure duration
Description
Time in minutes
Time Frame
During surgical procedure
Title
Duration of hepatic blood inflow reduction
Description
Time in minutes
Time Frame
During surgical procedure
Title
Estimated blood loss during surgery
Description
mL
Time Frame
During surgical procedure
Title
Number and type of blood transfusions during hospitalization
Description
Platelets, Erythrocytes, Plasma
Time Frame
During surgical procedure
Title
Duration of Intensive Care Unit (ICU) stay
Description
Time in Days
Time Frame
During hospitalization up to hospital discharge after the surgical procedure, estimated up to 30 days
Title
Total hospitalization time
Description
Time in Hours
Time Frame
From surgery to discharge from the ICU, estimated up to 30 days
Title
Postoperative drainage volume, characteristics, and duration
Description
Serous, sanguineous, serosanguineous, other Sanguineous Serosanguinous Serous, Sanguineous, Serosanguineous, Purulent, Other
Time Frame
During hospitalization up to hospital discharge after the surgical procedure, estimated up to 30 days
Title
Rate of subjects requiring reoperation
Description
Occurrence yes/no
Time Frame
During postoperative 3-months follow-up
Title
Rate of subjects with liver resection surface complications on ultrasound
Description
Fluid collection, biloma, hematoma, patch encapsulation, patch rolling up on the surface
Time Frame
At 6 week follow-up visit
Title
Amount of hemostatic material needed versus bleeding surface
Description
cm2 patch per cm2 bleeding
Time Frame
During surgical procedure
Title
GATT-Patch device-specific user satisfaction questionnaire
Description
Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) with (strongly) agreeing meaning a better outcome
Time Frame
At completion of the surgical procedure, at day 0

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is scheduled to undergo elective minimally invasive (robotic or laparoscopic) surgery on the liver, including cholecystectomy Subject is willing and able to give written informed consent for the clinical investigation participation Subjects is 22 years of age or older at the time of enrollment; and Subject has been informed of the nature of the clinical investigation. A subject must meet all of the following intra-operative inclusion criteria to be enrolled into the clinical investigation: Subject undergoes a fully minimally invasive surgical approach without the use of a hand port at the time of randomization and application of the patch; Subject in whom the Investigator is able to identify a target bleeding site at the liver resection plane for which any applicable conventional means for hemostasis (e.g. suture, ligature or cautery) are ineffective or impractical, and the choice is made to use a hemostatic agent to stop the bleeding Pressure on the surface of the hemostatic agent can be applied with the minimally invasive instruments to achieve hemostasis Subject has a target bleeding site with a SBSS of 1, 2, or 3 (e.g. reflecting minimal, mild or moderate bleeding severities) Exclusion Criteria: The target bleeding site is from a large defect in an artery or vein that requires vascular reconstruction with maintenance of vessel patency Subject is scheduled to undergo surgery on organs other than the liver and its associated biliary and vascular system Subject is scheduled to undergo a staged liver surgery procedure (e.g., Associating Liver Partition and Portal vein ligation for Staged hepatectomy [ALPPS]) Subject is taking multiple antithrombotic therapies in therapeutic dosage up to the time of surgery, but allowing exclusive use of acetylsalicylic acid Subject has platelet count <100 x 109/L, an activated partial thrombin time of >100s, or international normalized ratio >2.5 Subject has a total bilirubin level of ≥2.5 mg/dl Subject is pregnant, planning on becoming pregnant or actively breastfeeding during the 3-month follow-up period Subject has a known hypersensitivity to brilliant blue (FD&C Blue #1), porcine gelatin Subject who has religious objections to receiving products containing porcine Subject has an active or suspected infection at the bleeding site Subject in whom the investigational device will be used at the site of a synthetic graft or patch implant Subject has a life expectancy of less than 3 months Subject has a documented severe congenital or acquired immunodeficiency Subject has had or has planned to receive any organ transplantation Subject undergoes surgery with the indication of being a living liver donor Subject is currently participating or has participated in another clinical investigation within the past 30 days that may affect the endpoints of the study, such as trials related to the surgical procedure and anti-coagulation Subject is not appropriate for inclusion in the clinical investigation, per the medical opinion of the Investigator Subject has any incidental (pre- and peri-operative) findings deemed by the Investigator to potentially jeopardize the safety or welfare of the subject
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stuart Head, MD PhD
Phone
+31645306042
Email
s.head@gatt-tech.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ingrid Fossan
Phone
+31653538551
Email
i.fossan@gatt-tech.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stuart Head, MD PhD
Organizational Affiliation
GATT Technologies BV
Official's Role
Study Director
Facility Information:
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Navpreet Kaur
First Name & Middle Initial & Last Name & Degree
Valentina Rodina
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Jason Wellen
First Name & Middle Initial & Last Name & Degree
Kathleen McDonnell
Facility Name
Weill-Cornell
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Ben Samstein
First Name & Middle Initial & Last Name & Degree
Mateo Noriega
Facility Name
Atrium Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof David Iannitti
First Name & Middle Initial & Last Name & Degree
Katheryn Peterson
Facility Name
Intermountain Healthcare
City
Murray
State/Province
Utah
ZIP/Postal Code
84111
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Jean Botha
First Name & Middle Initial & Last Name & Degree
Jake Krong

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Undecided
Citations:
PubMed Identifier
28699748
Citation
Boerman MA, Roozen E, Sanchez-Fernandez MJ, Keereweer AR, Felix Lanao RP, Bender JCME, Hoogenboom R, Leeuwenburgh SC, Jansen JA, Van Goor H, Van Hest JCM. Next Generation Hemostatic Materials Based on NHS-Ester Functionalized Poly(2-oxazoline)s. Biomacromolecules. 2017 Aug 14;18(8):2529-2538. doi: 10.1021/acs.biomac.7b00683. Epub 2017 Jul 25.
Results Reference
background
PubMed Identifier
34536065
Citation
Roozen EA, Warle MC, Lomme RMLM, Felix Lanao RP, van Goor H. New polyoxazoline loaded patches for hemostasis in experimental liver resection. J Biomed Mater Res B Appl Biomater. 2022 Mar;110(3):597-605. doi: 10.1002/jbm.b.34938. Epub 2021 Sep 18.
Results Reference
background
Links:
URL
http://www.gatt-tech.com
Description
GATT Technologies B.V. website

Learn more about this trial

GATT-Patch Versus SURGICEL® Original in Minimally Invasive Liver and Gallbladder Surgery

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