Open Vs. Endoscopic Transversus Abdominis Release Trial

NCT ID: NCT06195332

Last Updated: 2024-12-18

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

RECRUITING

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-15

Study Completion Date

2025-12-31

Brief Summary

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This study aims to comparatively evaluate the early and long-term results of open and endoscopic TAR procedure for large midline incisional ventral hernias.

Detailed Description

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Minimally invasive (endoscopic) transversus abdominis release (TAR) - new technique for the treatment of patients with large incisional ventral hernia. Term "endoscopic" TAR combines two minimally invasive (laparosopic or extraperitoneal (eTEP) approaches. These techniques have demonstrated significant advantages compared with open TAR in several retrospective studies. There are currently no randomized trials comparing open and endoscopic TAR operations for incisional ventral hernia repair.This study aims to comparatively evaluate the early and long-term results of open and endoscopic TAR procedure for large midline incisional ventral hernias.

The sample size was determined based on a previously conducted retrospective pilot study comparing the results of open and endoscopic TAR procedures for midline incisional ventral hernia repair. The retrospective study included 133 patients with midline incisional ventral hernias who were underwent Rives-Stoppa hernia repair in combination with bilateral posterior component separation with transversus abdominis release via open (open TAR) or endoscopic (eTAR) technique in Moscow City Hospital №1 from January 2018 to December 2022. All patients were included in the study, starting from the moment of endoscopic TAR technique was introduced into the clinic. At the same time, the learning curve for the open TAR had already been reached at that time; more than 20 open TAR interventions were performed in the clinic in 2016-2017. The average hospitalization time in open TAR group was 6.7 ± 2.14 days. In endoscopic TAR group the average hospitalization time after surgery was 5.2 ± 1.65 bed days. After achieving the learning curve (20 operations) for the endoscopic TAR procedure technique average hospitalization period after surgery was 4.8 ± 1.47 days. Thus, a decrease in the duration of hospitalization in endoscopic TAR group after reaching the learning curve was noted by 28.4%. This fact, based on a retrospective pilot study, allows the investigators to assume as a hypothesis for this RCT a reduction in the duration of hospitalization during endoscopic TAR by at least 30% as a guideline for calculating the power of the study. Thus, assuming a Type I error probability α of 0.05 and a Type 2 error probability β of 0.20, it would require a total sample size of 36 patients (18 patients in each group).

Conditions

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Incisional Hernia of Midline of Abdomen

Keywords

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incisional hernia eTEP open TAR endoscopic TAR transversus abdominis release

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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open TAR

Open transversus abdominis release procedure will be use as combine open procedure Rives-Stoppa hernia repair in combination with bilateral transversus abdominis release with retromuscular mesh placement

Group Type ACTIVE_COMPARATOR

open TAR

Intervention Type PROCEDURE

Participants will undergo open TAR repair according to the assigned treatment arm.

endoscopic TAR

Endoscopic transversus abdominis release procedure will be use as combine minimally invasive Rives-Stoppa hernia repair in combination with bilateral transversus abdominis release via endoscopic technique with retromuscular mesh placement

Group Type ACTIVE_COMPARATOR

endoscopic TAR

Intervention Type PROCEDURE

Participants will undergo endoscopic TAR repair according to the assigned treatment arm.

Interventions

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open TAR

Participants will undergo open TAR repair according to the assigned treatment arm.

Intervention Type PROCEDURE

endoscopic TAR

Participants will undergo endoscopic TAR repair according to the assigned treatment arm.

Intervention Type PROCEDURE

Other Intervention Names

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open transversus abdominis release endoscopic transversus abdominis release

Eligibility Criteria

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Inclusion Criteria

* midline incisional hernia
* defect width from 8 till 12 cm
* ASA I-III class
* able to give informed consent
* elective hernia repair
* considered eligible for minimally invasive ventral hernia repair

Exclusion Criteria

* primary ventral hernia
* lateral hernia with/without midline
* refuse to give informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 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

Phone: +79163904180

Email: [email protected]

Georgy Ivakhov, professor

Role: CONTACT

Phone: +79262844224

Facility Contacts

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Georgy Ivakhov, Prof

Role: primary

Other Identifiers

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2907-2/22

Identifier Type: -

Identifier Source: org_study_id