ClinicalTrials.gg
Not yet recruitingNCT06881602TOTEMUpdated Sep 29, 2025

Remote Clinical Monitoring After Robotic Distal Pancreatectomy

An interventional study of Remote clinical monitoring in Digital Health, sponsored by Jessa Hospital. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-09-29.

Sponsored by Jessa Hospital · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This feasibility trial has three main objectives:

  • To investigate the impact of the transmural care pathway TOTeM on the Length of Stay (LOS) for patients undergoing robotic distal pancreatectomy.
  • To investigate the feasibility of the implementation of TOTeM for patients undergoing robotic distal pancreatic surgery, we will measure the recruitment rate by tracking the number of eligible patients who are approached for participation, the percentage who consent to join the study over a specified time period, and the adherence rate which describes how well participants follow the study protocol including the prescribed interventions or follow-up assessments.
  • Assessment of the potential changes in medical costs and outcomes for the purpose of performing a cost-effectiveness analysis from a hospital and patient perspective.
Read the detailed description

Due to fast progress and improvements in robotic surgery, minimally invasive procedures for complex surgery have become increasingly feasible for the vast majority of patients. Over recent years, minimally distal pancreatectomy (MDP) has become the preferred approach for distal pancreatectomy. This minimally invasive alternative offers less postoperative pain, better cosmetic outcomes, a quicker recovery, a shorter hospital stay, decreased morbidity, reduced intraoperative blood loss, and reduced health care costs. This shift in care models has enabled patients to return home more quickly after surgery, while their recovery continues to be closely monitored.

Hospitals are increasingly confronted with high bed occupancy rates and the need to use staff more efficiently. This has emphasized the importance of optimizing the length of stay for patients undergoing pancreatectomy, ensuring they can be discharged sooner without compromising their recovery. Early discharge from the hospital, combined with remote monitoring, offers a promising solution to these challenges. Thanks to advances in technology, patients can be monitored remotely after discharge by healthcare professionals allowing for early detection of potential complications and timely intervention, all while the patient recovers in the comfort of their own home. This approach also facilitates the effective implementation of transmurally coordinated care pathways (care delivered across different levels of the healthcare system), ensuring seamless communication and care transitions between hospital and home.

The TOTeM (Transmurale Opvolging met TeleMonitoring na chirurgie) project, supported by the Federale Overheidsdienst Volksgezondheid, Veiligheid van de Voedselketen en Leefmilieu, focuses on remote monitoring of patients with the help of wearable monitoring devices and a telemonitoring hub. Unlike the current approach where the patient is admitted to the intensive care unit (ICU) after surgery, patients will be immediately transferred to the ward. The patient is sent home after surgery as early as medically possible (as defined by reaching all of the time to be fit criteria), with qualitative and specialized follow-up in the home setting. The time to be fit criteria include: oral pain medication only, independent walking, oral intake, hemodynamically (90% of baseline blood pressure, heart rate in 90% of normal range) and respiratory (no need for extra oxygen) stable, and no drains or urinary catheters. After discharge, the patient is contacted by the telemonitoring hub through a daily videocall. Parameters are assessed up to three times a day. Follow-up via the mobile application and videocall is foreseen up to ten days postoperatively. The telemonitoring hub screens all input from the questionnaires completed by the patient as well as the parameters that are obtained via wearable monitoring devices. If necessary, the patient is contacted or an escalation protocol is triggered. The project aims to enable a faster recovery of patients in a familiar home environment and a more active role of the patient in their recovery process. For the hospital, the faster discharge offers the opportunity to optimize bed occupancy. On a societal level, the social cost of care may decrease.

This pilot and feasibility study focuses on the application of remote clinical monitoring following robotic distal pancreatectomy. By evaluating the feasibility and effect of the implementation of such a care model, this research aims to contribute to optimizing care for patients undergoing these complex procedures, while also alleviating pressure on hospital resources and staff.

02

Conditions studied

  • Digital Health

Keywords

  • Remote monitoring
  • Pancreatectomy
03

In context

Lead sponsor

Jessa Hospital is the lead sponsor of 85 studies on the registry; 17 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 18-75 years old
  • Competent to provide
  • Fluent in Dutch
  • Cognitively capable of understanding and engaging with the study
  • Undergoing robotic distal pancreatectomy
  • Owing a smartphone or has a caregiver who can assist
  • Does not live alone
  • Have a valid national identification number

Exclusion criteria

Exclusion Criteria:

  • Extended left pancreatectomy
  • Spleen-preserving procedure
  • Residing in a nursing home
  • Patients who are deemed unsuitable for the study by the physician based on clinical evaluation
  • Absence of or request to not participate in the study
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Remote clinical monitoring

    The application of remote clinical monitoring after a distal robotic pancreatectomy

    Procedure: Remote clinical monitoring

Interventions

  • ProcedureRemote clinical monitoring

    Patients after a distal pancreatectomy will be discharged faster from the hospital and will be remote monitored

06

What researchers measure

Primary outcomes

  1. Length of stay in hospital

    The primary outcome measurement for the TOTeM care pathway in patients undergoing robotic distal pancreatectomy is the length of stay, which is the total time measured from day of surgery to the day of hospital discharge

    Time frame: during hospital stay, an average of 4 days

Secondary outcomes

  1. Evaluation of the recruitment rate

    The feasibility of this pilot study is assessed by means of the recruitment rate, defined by the number of eligible patients who are approached for participation and the percentage who consent to join the study over a specified time period. The recruitment rate is defined as excellent if 20 patients can be enrolled in this study in one year.

    Time frame: during whole study period, an average of 1 year

  2. Evaluation of the adherence rate

    The feasibility of this pilot study is assessed by the adherence rate, which describes how well participants follow the study protocol including the prescribed interventions or follow-up assessments. The adherence rate is defined as excellent if ≥80% of the patients followed the study protocol including the prescribed interventions or follow-up assessments.

    Time frame: during whole study period, an average of 1 year

  3. Evaluation of medical costs

    Evaluation of the potential changes in medical costs for the hospital and for the individual patient

    Time frame: during study time of patient, an average of 3 months

  4. Assessment of surgical fear

    The short and long term surgical fear questionnaire will be evaluated at baseline, before the surgery. The short and long term questionnaire consist each of 4 questions, where 0 indicates no fear and 10 indicates extreme fear.

    Time frame: At baseline

  5. Quality of Life: EQ5D Questionnaire

    Questionnaire measuring patients' general health and quality of life: EQ5D = EuroQol-5 Dimensions: mobility, self-care, daily activities, pain/discomfort, anxiety/depression. A score of 0 represent a very low quality of life, where score of 1 represents the maximum score.

    Time frame: at baseline (day of surgery), Day7, Day28, Month3

  6. Quality of Life: SF-36 Questionnaire

    This questionnaire contains 36 questions and 8 dimensions: physical functioning, physical limitations, mental functioning, emotional limitations, social functioning, pain, general health, vitality. Scores for each domain range from 0 to 100, with a higher score defining a more favorable health state.

    Time frame: at baseline, Day 7, Day 28, Month 3

  7. Evaluation of the technology acceptance questionnaire

    Evaluation of the technology acceptance questionnaire, which contains 17 statements where patient can (completely) disagree, no opion or (completely) agree with.

    Time frame: baseline

  8. Pain scores (numerical rating scales)

    Evaluation of different pain scores (abdominal pain, lower abdominal pain, pain at wound stitch hole, shoulder pain and pain after eating). These are numerical rating scales with 0 having no pain at all and 10 having extreme pain.

    Time frame: 3 times per day for 10 days after the surgery

  9. Satisfaction of patients

    * Degree to which the patient is satisfied with the care pathway, felt safe during remote monitoring, and if they received sufficient information about the follow-up period. * Measured with Numeric Rating Scale (NRS), with 0 not satisfied at all and 10 extremely satisfied

    Time frame: on day 10 after the surgery

  10. Evaluation of pain medication

    Assessment of the number of pain medication taken every day after the surgery

    Time frame: daily up to 10 days after surgery

  11. Evaluation of the acceptability of the remote care pathway

    This wil be evaluated with a validated questionnaire containing 8 statements which the patient need to score as (completely) agree, no opinion or (completely) disagree

    Time frame: on postoperative day 10

  12. Evaluation of study patients admitted to the ICU

    The number of patients admitted to the ICU after surgery will be assessed

    Time frame: during study period, an average of 1 year

  13. Evaluation of unplanned medical consultations or visits

    Assessment of unplanned readmission rate and/or unscheduled home visits from a general practitioner or other medical doctor and/or emergency consultations

    Time frame: during study period of the patient, an average of 3 months

  14. Evaluation of post-operative complicatons

    Assessment of post-operative complications associated with distal pancreatectomy

    Time frame: during study period of the patient, an average of 3 months

  15. Evaluation of respiratory rate

    Assessment of the respiratory rate, defined in breaths per minute.

    Time frame: during 10 days after surgery

  16. Evaluation of the Intervention Appropriateness Measure

    This wil be evaluated with a validated questionnaire containing 8 statements which the patient need to score as (completely) agree, no opinion or (completely) disagree

    Time frame: on postoperative day 10

  17. Evaluation of the Feasibility of Intervention Measure

    This wil be evaluated with a validated questionnaire containing 8 statements which the patient need to score as (completely) agree, no opinion or (completely) disagree

    Time frame: on postoperative day 10

  18. Evaluation of temperature

    Assessment of the temperature of the patient, defined in °C.

    Time frame: during 10 days after surgery

  19. Evaluation of oxygen saturation in blood

    Assessment of oxygen saturation in blood, measured in %

    Time frame: during 10 days after surgery

07

Study locations

No study locations are listed for this record.

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 29, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06881602
Lead sponsor
Jessa Hospital
Responsible party
Stessel Björn (Professor, Dr, Jessa Hospital) — Principal investigator
First posted
Mar 18, 2025
Start date
Oct 1, 2025 (estimated)
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Sep 29, 2025

Study contacts

Bjorn Stessel, MD, PhD
Contact
bjorn.stessel@jessazh.be
+3211222107

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion