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TerminatedNCT01201564Updated May 7, 2019

Comparative Study Matching Intraperitoneal Onlay Mesh (IPOM) and Sublay Mesh to Treat Umbilical Hernia

A Phase 4 interventional study of intraperitoneal onlay mesh repair and sublay mesh repair in Umbilical Hernia, sponsored by University Hospital, Basel, Switzerland. Terminated at 3 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-05-07.

Sponsored by University Hospital, Basel, Switzerland · Phase 4, Interventional, and Treatment

Why this study was terminated
Recruiting problems
Phase
Phase 4
Study type
Interventional
Enrollment
306
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is designed to compare two techniques for operative care of umbilical hernia in adults regarding wound complications, wound side fluid collections, recurrence rate, postoperative pain, duration of hospitalization and quality of life. The IPOM technique provides mesh positioning directly into the abdominal cavity onto the defect under laparoscopic control while in sublay position the mesh is placed directly behind the rectus muscle after small incision close to the belly button.

02

Conditions studied

  • Umbilical Hernia

Keywords

  • umbilical hernia,
  • wound complications,
  • mesh repair, IPOM,
  • quality of life,
  • sublay mesh repair,
  • recurrence rate
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • informed consent
  • patient age: ≥ 18 years
  • elective surgery for umbilical hernia
  • hernia diameter ≥ 1cm

Exclusion criteria

Exclusion Criteria:

  • previous history of median laparotomy
  • navel site infection
  • contraindication for general anaesthesia
  • American Society of Anesthesiologists (ASA) score >IV
  • pregnancy
  • cirrhosis of the liver (CHILD B and C) and/or ascites
  • cytostatic therapy
  • incarcerated hernia
  • recurrent hernia
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
306 participants (actual)

Study arms

  • Active comparator
    intraperitoneal onlay mesh repair

    Procedure: intraperitoneal onlay mesh repair

  • Active comparator
    sublay mesh repair

    Procedure: sublay mesh repair

Interventions

  • Procedureintraperitoneal onlay mesh repair

    The IPOM technique provides mesh positioning directly into the abdominal cavity onto the defect under laparoscopic control while in sublay position the mesh is placed directly behind des rectus muscle after small incision close to the belly button.

  • Proceduresublay mesh repair

    The IPOM technique provides mesh positioning directly into the abdominal cavity onto the defect under laparoscopic control while in sublay position the mesh is placed directly behind des rectus muscle after small incision close to the belly button.

05

What researchers measure

Primary outcomes

  1. early wound complications

    * wound infection (with or without removal of the mesh) * wound necrosis * wound hematoma

    Time frame: 30 days after operation

  2. late wound complications

    * wound infection (with or without removal of the mesh) * wound necrosis * wound hematoma

    Time frame: 1 year after operation

Secondary outcomes

  1. complication rate perioperative

    * major bleeding * bowel injury

    Time frame: intraoperative complications will be recorded immediately after finishing the operation

  2. duration of operation

    measured in minutes according to operations protocol (duration cut - suture)

    Time frame: the duration will be recorded immediately after finishing the operation

  3. hospital stay

    measured in days

    Time frame: will be measured after discharge of the patient

  4. umbilical hernia recurrence rate

    the diagnosis of recurrence will be given by the surgeon clinically or due to ultrasound scan

    Time frame: 30 days

  5. umbilical hernia recurrence rate

    the diagnosis of recurrence will be given by the surgeon clinically or due to ultrasound scan

    Time frame: 1 year

  6. umbilical hernia recurrence rate

    the diagnosis of recurrence will be given by the surgeon clinically or due to ultrasound scan

    Time frame: 3 years

  7. umbilical hernia recurrence rate

    the diagnosis of recurrence will be given by the surgeon clinically or due to ultrasound scan

    Time frame: 5 years

  8. navel site seroma

    the diagnosis of seroma will be given by the surgeon clinically or by ultrasound scan and measured in ccm (height(cm) x width(cm)x length(cm))

    Time frame: discharge day

  9. navel site seroma

    the diagnosis of seroma will be given by the surgeon clinically or by ultrasound scan and measured in ccm (height(cm) x width(cm)x length(cm))

    Time frame: after 30 days

  10. navel site seroma

    the diagnosis of seroma will be given by the surgeon clinically or by ultrasound scan and measured in ccm (height(cm) x width(cm)x length(cm))

    Time frame: after 1 year

  11. complication rate postoperative

    * trocar site hernia * enteral fistula * persistent pain * re-operation

    Time frame: 30 day

  12. complication rate postoperative

    * trocar site hernia * enteral fistula * persistent pain * re-operation

    Time frame: 1 year

  13. complication rate postoperative

    * trocar site hernia * enteral fistula * persistent pain * re-operation

    Time frame: 3 years

  14. complication rate postoperative

    * trocar site hernia * enteral fistula * persistent pain * re-operation

    Time frame: 5 years

  15. pain score (Visual Analog Scale - VAS)

    will be measured by the nurse according to Visual Analog Scale

    Time frame: 24h post operative

  16. pain score (Visual Analog Scale - VAS)

    will be measured by the nurse according to Visual Analog Scale

    Time frame: 48h post operative

  17. pain score (Visual Analog Scale - VAS)

    will be measured by the nurse according to Visual Analog Scale

    Time frame: immediately before discharge

  18. Quality of life (SF-36)

    patients will be asked to fulfill validated SF-36 questionnaire

    Time frame: 1 day pre-operative

  19. Quality of life (SF-36)

    patients will be asked to fulfill validated SF-36 questionnaire

    Time frame: 30 days postoperatively

  20. Quality of life (SF-36)

    patients will be asked to fulfill validated SF-36 questionnaire

    Time frame: 1 year postoperatively

06

Study locations

3 sites
  • Diakoniekrankenhaus Rotenburg (Wuemme) gGmbH
    Rotenburg, Niedersachsen 27356, Germany
  • University Hospital Basel
    Basel, 4031, Switzerland
  • Luzerner Kantonsspital
    Luzern, 6000, Switzerland
07

References and documents

Publications

  • Benhidjeb T, Benecke C, Strik MW. [Incisional hernia repair: sublay or intraperitoneal onlay mesh (IPOM)?]. Zentralbl Chir. 2008 Sep;133(5):458-63. doi: 10.1055/s-2008-1076954. Epub 2008 Oct 15. German. PubMed 18924044 ↗
  • Lau H, Patil NG. Umbilical hernia in adults. Surg Endosc. 2003 Dec;17(12):2016-20. doi: 10.1007/s00464-003-9027-7. Epub 2003 Oct 28. PubMed 14574545 ↗
  • Mayo WJ. VI. An Operation for the Radical Cure of Umbilical Hernia. Ann Surg. 1901 Aug;34(2):276-80. doi: 10.1097/00000658-190107000-00021. No abstract available. PubMed 17861015 ↗
  • Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000 Aug 10;343(6):392-8. doi: 10.1056/NEJM200008103430603. PubMed 10933738 ↗
  • Venclauskas L, Silanskaite J, Kiudelis M. Umbilical hernia: factors indicative of recurrence. Medicina (Kaunas). 2008;44(11):855-9. PubMed 19124962 ↗
  • Hilling DE, Koppert LB, Keijzer R, Stassen LP, Oei IH. Laparoscopic correction of umbilical hernias using a transabdominal preperitoneal approach: results of a pilot study. Surg Endosc. 2009 Aug;23(8):1740-4. doi: 10.1007/s00464-008-0177-5. Epub 2008 Nov 18. PubMed 19015918 ↗
  • Forbes SS, Eskicioglu C, McLeod RS, Okrainec A. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009 Aug;96(8):851-8. doi: 10.1002/bjs.6668. PubMed 19591158 ↗
  • Bullinger M. [Assessment of health related quality of life with the SF-36 Health Survey]. Rehabilitation (Stuttg). 1996 Aug;35(3):XVII-XXVII; quiz XXVII-XXIX. German. PubMed 8975342 ↗
08

Registry details

Key details

Study ID
NCT01201564
Lead sponsor
University Hospital, Basel, Switzerland
Collaborators
Clinical Trial Unit, University Hospital Basel, Switzerland
Responsible party
Sponsor
First posted
Sep 14, 2010
Start date
Jul 2010
Primary completion
Dec 2018
Completion
Dec 2018
Last update
May 7, 2019

Study contacts

Daniel Oertli, Professor
study chair · Departement of General Surgery, University Hospital Basel, Switzerland
Oleg Heizmann, MD
study director · Departement of General,- Visceral- and Thoracic Surgery, Diakoniekrankenhaus Rotenburg (Wuemme), Germany
Daniel Matz, MD
principal investigator · Departement of General,- Visceral- and Thoracic Surgery, Diakoniekrankenhaus Rotenburg (Wuemme), Germany

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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