No abdominal incision in minimally invasive colorectal surgery: a multicenter registry of natural orifice specimen extraction

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

AP-NOSES is a prospective, multicenter observational registry coordinated by Singapore General Hospital that tracks clinical and patient-reported long-term outcomes after minimally invasive colorectal resection with either natural orifice specimen extraction (NOSE) or transabdominal extraction. The primary comparison looks at time to incisional hernia within 24 months between NOSE-eligible patients planned for NOSE versus those planned for transabdominal extraction. Secondary endpoints include postoperative complications, extraction-related morbidity, and patient-reported outcomes, with a focus on long-term abdominal wall health. Eligible participants are adults 21 or older undergoing elective laparoscopic or robotic colorectal resection with planned intact specimen extraction, enrolled at tertiary centers in the Asia-Pacific region.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 21 years or older
* Elective minimally invasive colorectal resection (laparoscopic or robotic intent)
* Planned intact specimen extraction
* Eligible for natural orifice specimen extraction (NOSE) or transabdominal specimen extraction according to study protocol
* Ability to provide informed consent

Exclusion Criteria:

* Emergency colorectal surgery
* Planned transanal total mesorectal excision (TaTME)
* Planned ultralow anterior resection with planned anastomosis 3 cm or less from the anal verge
* Planned abdominoperineal resection (APR)
* Planned permanent end stoma without restoration of intestinal continuity
* Planned multivisceral resection
* Generalized peritonitis or uncontrolled intra-abdominal sepsis
* Pregnancy
* Pre-existing ventral or incisional hernia at the planned extraction site
* Planned specimen extraction through a prior laparotomy incision containing mesh
* Fixed distal obstruction, severe pelvic stenosis, or other anatomical constraint precluding intact specimen extraction

Where it's running

• Singapore General Hospital
  Singapore, Singapore Recruiting

Study contacts

• Study coordinator: Isaac Seow-En, MBBS, FRCSEd
• Email: isaac.seow.en@singhealth.com.sg
• Phone: +6563213853

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.