Laparoscopic IPOM Plus vs. eTEP Trial

NCT ID: NCT05528107

Last Updated: 2023-03-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-14

Study Completion Date

2024-03-31

Brief Summary

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The survey will compare primary and secondary outcomes of laparoscopic intraperitoneal onlay mesh (IPOM plus) and extended totally extraperitoneal (eTEP) repair for incisional hernia.

The research hypothesis is the following: patients who underwent eTEP repair may experience 30% less pain, assessed on the NRS-11 scale by the end of postoperative day 1, compared with IPOM plus procedure

Detailed Description

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The use of minimally invasive surgery for the treatment of patients with incisional ventral hernias has significant advantages over open surgery. According to the current guidelines, the optimal technique for IPOM repair is a combination of suturing hernia defect and implantation an intraperitoneal anti-adhesive coated mesh prosthesis - the so-called "IPOM plus" technology (R.Bittner et al., 2019). The development of laparoscopic surgery has led to the new minimally invasive technique for ventral hernia repair - extended-view totally extraperitoneal plasty (eTEP) (I. Belyansky et al., 2018). An important advantage of eTEP is the non-fixation technique of implant placement due to correct positioning compared to the need for combined fixation for IPOM or IPOM plus, which probably affects on the level of postoperative pain in the early postoperative period.

The results of the first RCT comparing IPOM and eTEP ventral hernia repair were recently published (Mayank J. et al., 2022). It was demonstrated the benefits of eTEP repair in several aspects: less pain in the early postoperative period, as well as a faster return to physical activity and lower intervention costs. However, a significant limitation of this RCT is the analysis of interventions in a mixed group of patients with primary ventral and incisional hernias, as well as the use of IPOM procedure without suturing the hernia defect.

The sample size was determined based on the above hypothesis regarding the primary point of the study. Considering trial of Asencio F. et al. (2009) in a group of patients with incisional ventral hernias, the level of pain at the end of the first postoperative day after IPOM repair was 4.76 according to the VAS (visual analog scale) with a standard deviation of 1.975. Assuming α (type I error rate) 0.05, β 0.20, it would need a total sample size of 60 patients. Taking into account the probability of loss of patients in the evaluation of long-term results up to 20%, 72 patients will be required (36 patients per group).

Taking into account the inconsistency of the literature data on the level of pain in the early postoperative period after IPOM procedure for incisional ventral hernia repair, as well as the established primary point of the study, the investigators plan an additional calculation with correction of the sample size after evaluation intermediate results upon reaching 50% of enrolled patients of the initially established.

Conditions

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Incisional Hernia of Midline of Abdomen

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Laparoscopic Intraperitoneal Onlay Mesh plus ventral hernia repair

Laparoscopic Intraperitoneal Onlay Mesh plus repair will be used to perform a minimally invasive ventral hernia repair with intraperitoneal mesh placement and suturing hernia defect.

Group Type ACTIVE_COMPARATOR

Lap IPOM plus

Intervention Type PROCEDURE

Participants will undergo Lap IPOM plus repair according to the assigned treatment arm.

Extended-view totally extraperitoneal ventral hernia repair

Extended-view totally extraperitoneal ventral hernia repair will be used to perform minimally invasive ventral hernia repair with retrorectus mesh placement

Group Type ACTIVE_COMPARATOR

eTEP

Intervention Type PROCEDURE

Participants will undergo eTEP repair according to the assigned treatment arm.

Interventions

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Lap IPOM plus

Participants will undergo Lap IPOM plus repair according to the assigned treatment arm.

Intervention Type PROCEDURE

eTEP

Participants will undergo eTEP repair according to the assigned treatment arm.

Intervention Type PROCEDURE

Other Intervention Names

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Laparoscopic Intraperitoneal Onlay Mesh plus ventral hernia repair Extended-view totally extraperitoneal ventral hernia repair

Eligibility Criteria

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Inclusion Criteria

* midline incisional hernia
* defect width 2-6 cm
* ASA I-II class
* Elective hernia repair
* Considered eligible for minimally invasive ventral hernia repair
* Able to give informed consent
* Able to tolerate general anesthesia

Exclusion Criteria

* primary ventral herna
* lateral hernia with/without midline
* defect width more than 6 cm
* refuse to give informed consent
* prior mesh placement in the retrorectus space
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pirogov Russian National Research Medical University

OTHER

Sponsor Role collaborator

City Clinical Hospital No.1 named after N.I. Pirogov

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Clinical City Hospital #1 named after N.I. Pirogov

Moscow, , Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Alexander Sazhin, professor

Role: CONTACT

+79163904180

Georgy Ivakhov, PhD

Role: CONTACT

+79262844224

Facility Contacts

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Georgy Ivakhov, Prof

Role: primary

+79264578568

Other Identifiers

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2907-1/22

Identifier Type: -

Identifier Source: org_study_id

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