Registry of colorectal surgery that removes tissue without a belly incision
Follows people having colorectal surgery, comparing two ways of removing the specimen.
Plain-language title generated from the registry record
Registry title: AP-NOSES: A Prospective Multicentre Registry of Natural Orifice Specimen Extraction in Minimally Invasive Colorectal Surgery
Key facts
- Where
- Singapore, SingaporeSee the site
Where in Singapore
- Singapore General HospitalSingapore, SingaporeTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Singapore General Hospital
- Trial code
- NCT07615036
- Record updated
- 29 May 2026
- Original description
Natural orifice specimen extraction (NOSE) is a minimally invasive colorectal surgical technique in which the surgical specimen is removed through a natural orifice, including transanal or transvaginal routes, thereby avoiding an abdominal extraction incision. Observational studies suggest that NOSE may reduce wound-related morbidity and improve postoperative recovery, but prospective multicenter data evaluating long-term outcomes remain limited.Read full original descriptionShow less
AP-NOSES: A Prospective, Multicentre Registry of Natural Orifice Specimen Extraction in Minimally Invasive Colorectal Surgery Across the Asia-Pacific Region
Natural orifice specimen extraction (NOSE) is a minimally invasive colorectal surgical technique in which the surgical specimen is removed through a natural orifice, including transanal or transvaginal routes, thereby avoiding an abdominal extraction incision. Observational studies suggest that NOSE may reduce wound-related morbidity and improve postoperative recovery, but prospective multicenter data evaluating long-term outcomes remain limited.
AP-NOSES is a prospective, multicenter observational registry evaluating clinical, patient-reported, and long-term wound outcomes following minimally invasive colorectal surgery with NOSE or transabdominal specimen extraction. The primary objective is to compare time to incisional hernia within 24 months between NOSE-eligible patients undergoing planned NOSE extraction and NOSE-eligible patients undergoing planned transabdominal extraction.
Secondary objectives include evaluation of postoperative complications, extraction-related morbidity, bowel function, urinary and sexual function, oncologic outcomes, and long-term patient-reported and clinical outcomes across participating centers.
This study does not alter routine clinical care. Surgical technique, perioperative management, and follow-up are performed according to local institutional practice.
Inclusion: 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: Emergency colorectal surgery; Planned ultralow anterior resection with planned anastomosis 3 cm or less from the anal verge; Planned abdominoperineal resection (APR); Planned multivisceral resection; Planned specimen extraction through a prior laparotomy incision containing mesh; Planned transanal total mesorectal excision (TaTME); Planned permanent end stoma without restoration of intestinal continuity; Generalized peritonitis or uncontrolled intra-abdominal sepsis; Pregnancy; Pre-existing ventral or incisional hernia at the planned extraction site; Fixed distal obstruction, severe pelvic stenosis, or other anatomical constraint precluding intact specimen extraction.