Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN

Background:. The invisible fluid leaking from a partially resected pancreas is associated with complications including postoperative pancreatic fistula (POPF), calling for strategies to visualize intraoperative leakage. This single-arm, monocentric trial aims to evaluate the usefulness and safety of...

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Main Authors: Thomas M. Pausch, MD, Magdalena Holze, MD, Josefin El-Mahdy, Bodil Gesslein, PhD, Helena Ossmer Thedius, Anja Sander, PhD, Solveig Tenckhoff, PhD, Tom Sundermann, PhD, Jan Larmann, MD, Pascal Probst, PhD, Frank Pianka, MD, Rosa Klotz, MD, Thilo Hackert, MD
Format: Article
Language:English
Published: Wolters Kluwer Health 2025-03-01
Series:Annals of Surgery Open
Online Access:http://journals.lww.com/10.1097/AS9.0000000000000529
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author Thomas M. Pausch, MD
Magdalena Holze, MD
Josefin El-Mahdy
Bodil Gesslein, PhD
Helena Ossmer Thedius
Anja Sander, PhD
Solveig Tenckhoff, PhD
Tom Sundermann, PhD
Jan Larmann, MD
Pascal Probst, PhD
Frank Pianka, MD
Rosa Klotz, MD
Thilo Hackert, MD
author_facet Thomas M. Pausch, MD
Magdalena Holze, MD
Josefin El-Mahdy
Bodil Gesslein, PhD
Helena Ossmer Thedius
Anja Sander, PhD
Solveig Tenckhoff, PhD
Tom Sundermann, PhD
Jan Larmann, MD
Pascal Probst, PhD
Frank Pianka, MD
Rosa Klotz, MD
Thilo Hackert, MD
author_sort Thomas M. Pausch, MD
collection DOAJ
description Background:. The invisible fluid leaking from a partially resected pancreas is associated with complications including postoperative pancreatic fistula (POPF), calling for strategies to visualize intraoperative leakage. This single-arm, monocentric trial aims to evaluate the usefulness and safety of SmartPAN, a hydrogel that reacts to alkali pancreatic fluids by changing color and thus enables the surgeon to take immediate action to close leakage. Methods:. Patients awaiting partial pancreatic resection for any indication were recruited to receive intraoperative SmartPAN application. Trial endpoints covered SmartPAN usability and safety according to reports completed by surgeons after each operation, laboratory measurements of nonbiodegradable compounds in body fluids, and clinical evaluations over 30 days of follow-up. Results:. In total 42 patients were recruited to the trial and 29 received partial pancreatic resection with SmartPAN application according to protocol. All 16 attending surgeons rated SmartPAN as easy to learn and use, mostly agreeing that it was useful and that they intended to use it frequently. No adverse effects or complications were associated with SmartPAN, nor were its compounds detected in blood or abdominal fluids. Positive leakage response was detected in 10/29 surgeries. POPF developed in 7 patients, including 2 intraoperatively detected leakages, thereof 1 with targeted closure as well as 5 with no leakage detected. Conclusion:. This study represents the first-in-human clinical trial of SmartPAN and the precursor to randomized controlled trials. The outcomes support SmartPAN’s clinical usability and safety and showcase the device’s potential to intraoperatively visualize precursors of POPF.
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spelling doaj-art-7b0d2aa279fd40fb8af990f4995a5c6e2025-08-20T02:42:08ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932025-03-0161e52910.1097/AS9.0000000000000529202503000-00029Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPANThomas M. Pausch, MD0Magdalena Holze, MD1Josefin El-Mahdy2Bodil Gesslein, PhD3Helena Ossmer Thedius4Anja Sander, PhD5Solveig Tenckhoff, PhD6Tom Sundermann, PhD7Jan Larmann, MD8Pascal Probst, PhD9Frank Pianka, MD10Rosa Klotz, MD11Thilo Hackert, MD12From the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyFrom the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyFrom the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany‡ Magle Chemoswed AB, Malmö, Sweden‡ Magle Chemoswed AB, Malmö, Sweden§ Institute of Medical Biometry, Heidelberg University Hospital, Heidelberg, Germany† Study Centre of the German Society of Surgery (SDGC), Heidelberg University, Heidelberg, Germany∥ Institute of Forensic and Traffic Medicine, Heidelberg University Hospital, Heidelberg, Germany¶ Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, GermanyFrom the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyFrom the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyFrom the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyFrom the * Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, GermanyBackground:. The invisible fluid leaking from a partially resected pancreas is associated with complications including postoperative pancreatic fistula (POPF), calling for strategies to visualize intraoperative leakage. This single-arm, monocentric trial aims to evaluate the usefulness and safety of SmartPAN, a hydrogel that reacts to alkali pancreatic fluids by changing color and thus enables the surgeon to take immediate action to close leakage. Methods:. Patients awaiting partial pancreatic resection for any indication were recruited to receive intraoperative SmartPAN application. Trial endpoints covered SmartPAN usability and safety according to reports completed by surgeons after each operation, laboratory measurements of nonbiodegradable compounds in body fluids, and clinical evaluations over 30 days of follow-up. Results:. In total 42 patients were recruited to the trial and 29 received partial pancreatic resection with SmartPAN application according to protocol. All 16 attending surgeons rated SmartPAN as easy to learn and use, mostly agreeing that it was useful and that they intended to use it frequently. No adverse effects or complications were associated with SmartPAN, nor were its compounds detected in blood or abdominal fluids. Positive leakage response was detected in 10/29 surgeries. POPF developed in 7 patients, including 2 intraoperatively detected leakages, thereof 1 with targeted closure as well as 5 with no leakage detected. Conclusion:. This study represents the first-in-human clinical trial of SmartPAN and the precursor to randomized controlled trials. The outcomes support SmartPAN’s clinical usability and safety and showcase the device’s potential to intraoperatively visualize precursors of POPF.http://journals.lww.com/10.1097/AS9.0000000000000529
spellingShingle Thomas M. Pausch, MD
Magdalena Holze, MD
Josefin El-Mahdy
Bodil Gesslein, PhD
Helena Ossmer Thedius
Anja Sander, PhD
Solveig Tenckhoff, PhD
Tom Sundermann, PhD
Jan Larmann, MD
Pascal Probst, PhD
Frank Pianka, MD
Rosa Klotz, MD
Thilo Hackert, MD
Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN
Annals of Surgery Open
title Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN
title_full Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN
title_fullStr Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN
title_full_unstemmed Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN
title_short Visualization of Intraoperative Pancreatic Leakage (ViP): The IDEAL Stage I First-in-human, Single-arm Clinical Pilot Trial of SmartPAN
title_sort visualization of intraoperative pancreatic leakage vip the ideal stage i first in human single arm clinical pilot trial of smartpan
url http://journals.lww.com/10.1097/AS9.0000000000000529
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