Virtual Technology to improve the management of perianal Crohn's
Research type
Research Study
Full title
A feasibility study to assess a "Virtual" (vEUA) Technology to improve the management of perianal Crohn’s disease
IRAS ID
323058
Contact name
Jonathan Evans
Contact email
Sponsor organisation
Nottingham University Hospital NHS Trust
Duration of Study in the UK
2 years, 0 months, 7 days
Research summary
Around 1 in 3 people with Crohn’s will likely develop a fistula at some point. Perianal fistulas connect the anal canal or rectum to the surface of the skin near the anus. Fistulas may be managed with medicines, surgery, or a combination of both. The goal of surgery is to heal the fistula while avoiding damage to the anal sphincter muscles. These muscles surround the anus and control the release of poo.
People with a perianal fistula are usually referred to see a surgeon. They will have an MRI scan and an examination under anaesthesia. This allows any abscesses to be drained and a seton to be placed. A seton is a soft surgical thread that is tied through the fistula and allows the pus and infected tissue to drain away.
Abscesses or fistulas can be difficult to identify during an examination under anaesthesia. This can lead to ongoing infections and a need for further surgeries. This causes scarring and delays the medical treatment after surgery that allows fistulas to heal. Multiple or incorrectly performed surgeries can also damage the anal sphincter muscles, leading to incontinence.We believe that improving how information on the fistula is communicated from the MRI scans to the surgeon is critical – it will improve how surgeons find and treat fistulas during surgery
Advances in digital technology allow fistulas and the surrounding body structures to be seen in 3D. This technology is called Virtual Examination Under Anaesthesia (vEUA). vEUA allows the surgeon to better understand the anatomy of and around the fistula, alongside the usual MRI report.
This research project will investigate whether vEUA increases confidence and ability of surgeons in identifying and treating fistulas. The researchers will also see whether using vEUA improves the quality of life of people having surgery to treat a perianal fistula.
REC name
HSC REC A
REC reference
23/NI/0112
Date of REC Opinion
3 Oct 2023
REC opinion
Further Information Favourable Opinion