Reducing long-term pain after lung resection using transthoracic, out-of-cage, or hybrid robotic approaches
Chronic Pain After Thoracic Surgery: Towards a New Standard? A Comparative Prospective Study of Pain Reduction After Pulmonary Resection by RATS-TT, RATS-OTC, and Hybrid RATS.
We will test whether using subcostal/subxiphoid ('out of cage') or a hybrid robotic approach causes less chronic pain than standard transthoracic robotic surgery in adults having lung resection.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 120 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Centre hospitalier de l'Université de Montréal (CHUM) Academic / other |
| Locations | 1 site (Montreal, Quebec) |
| Trial ID | NCT07184463 on ClinicalTrials.gov |
What this trial studies
This observational study compares chronic pain outcomes at 3 and 6 months after pulmonary resection performed with three robotic approaches: transthoracic RATS (RATS-TT), out-of-cage RATS (RATS-OTC), and a hybrid RATS technique. The rationale is that intercostal trocars used in transthoracic approaches can injure intercostal nerves and lead to chronic pain, while subcostal/subxiphoid ports avoid the intercostal space. Patients aged 18 and older with ASA scores 1–3 who undergo robotic pulmonary resection at CHUM will be followed and asked to complete standardized pain assessments. The study will compare the frequency and severity of chronic pain and related opioid use across the three technique groups.
Who should consider this trial
Good fit: Adult patients (18+) with ASA 1–3 undergoing robotic pulmonary resection at CHUM who can provide consent and complete postoperative pain assessments are ideal candidates.
Not a fit: Patients with language, psychiatric, cognitive, or physical barriers to pain assessment, those who refuse participation, or those who require reoperation by VATS or thoracotomy postoperatively are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, the work could identify surgical approaches that reduce the risk of chronic post-thoracic surgery pain and lower long-term opioid needs after lung resection.
How similar studies have performed: A French team reported reduced opioid use and lower acute postoperative pain with the RATS-OTC approach, but chronic pain outcomes have not yet been established in larger or comparative cohorts.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients aged 18 years and older * American Society of Anesthesiologists (ASA) score 1-3 Exclusion Criteria: * Language barrier, psychiatric, physical or mental condition making pain assessment impossible despite prior education * Patient refusal to participate * Patients reoperated by VATS or thoracotomy in the postoperative period in the context of the occurrence of complications
Where this trial is running
Montreal, Quebec
- Centre Hospitalier de l'Université de Montreal — Montreal, Quebec, Canada (Recruiting)
Study contacts
- Principal investigator: Alex Moore, MD — Chum
- Study coordinator: Alex Moore, MD
- Email: alex.moore.med@ssss.gouv.qc.ca
- Phone: 514-890-8000
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.