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CompletedNCT03434301TACKoMeshUpdated Dec 7, 2021

Comparison of Mesh Fixation Techniques in Elective Laparoscopic Repair of Incisional Hernia - ReliaTack™ v ProTack™

An interventional study of ReliaTack™ and Protack™ in Incisional Hernia, Hernia and Abdominal Hernia, sponsored by Manchester University NHS Foundation Trust. Completed at 1 site in United Kingdom. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2021-12-07.

Sponsored by Manchester University NHS Foundation Trust · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
63
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

This study is designed to examine the effects on post operative pain after the use of a fixation device to secure a mesh in the abdomen to repair a hernia of the abdominal wall. The fixation devices to be used differ with one being made from titanium and is permanent and the other being made from an absorbable material. Both fixation devices are commonly used but two questions remain unanswered, does one cause more chronic pain and also what if any will be the effect on recurrence rates of the hernia. No trial has been undertaken to date which will not only examine the fixation device but in the setting where the hernia is closed first. The closure of the hernial defect by the keyhole technique is a relatively new and growing concept in the hernia world.

Read the detailed description

TACKoMESH study (Comparison of using absorbable tacks (ReliaTack™) against a non-absorbable tack (Protack™) to fixate Symbotex™ composite mesh in the elective repair of incisional hernia) is a prospective, single-centre, double blinded randomised trial which aims to establish whether the use of absorbable (ABS) compared to non-absorbable (Non-ABS) tacks in adult patients undergoing elective incisional hernia repair produces a lower rate of pain both immediately and long-term. Secondary outcomes to be explored include seroma formation, hernia recurrence, length of postoperative hospital stay, wound infection, reoperation rate, operation time, health related quality of life and time to return to normal daily activity.

Patients entering TACKoMesh will be randomised immediately prior to their operation with a 1:1 ratio of ABS versus Non-ABS tack arm allocation. The same composite mesh will be used for all operations. Follow-up is according to a predetermined schedule, using specifically designed Case Report Forms to collect the blinded data.

02

Conditions studied

  • Incisional Hernia
  • Hernia
  • Abdominal Hernia

Keywords

  • Surgery
  • Laparotomy
  • Tack
  • Non-absorbable Tack
  • Absorbable Tack
  • Pain
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • All adults undergoing elective incisional hernia repair for midline abdominal incisional hernia, with a defect of 3-10cm in diameter.

Exclusion criteria

Exclusion Criteria:

  • Patients less than 18 years of age, or unable to give informed consent.
  • Patients over 80 years of age.
  • Females of reproductive age.
  • Prisoners.
  • Clinically small incisional hernia \<3cm maximum diameter.
  • Emergency procedures (for irreducible, strangulated or obstructed hernia).
  • Procedure involving dirty (purulent inflammation (e.g. abscess); preoperative perforation of respiratory, gastrointestinal, biliary or genitourinary tract; penetrating trauma >4 hours old) or contaminated (Non-purulent inflammation; gross spillage from gastrointestinal tract; entry into biliary or genitourinary tract in the presence of infected bile or urine; major break in technique; penetrating trauma \<4 hours old; chronic open wounds to be grafted or covered) surgery.
  • Patients with a Body Mass Index (BMI) >40 kg/m².
  • Patients participating in any other study, whose concurrent participation in the TACK study might place them at undue risk or might confound the study data in the opinion of the chief investigators.
  • Failure to close the anterior rectus sheath intraoperatively.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Care provider)
Enrollment
63 participants (actual)

Study arms

  • Active comparator
    Mesh with absorbable tack fixation

    Mesh with absorbable tack (ReliaTack™) fixation

    Device: ReliaTack™

  • Active comparator
    Mesh with non-absorbable fixation

    Mesh with non-absorbable (Protack™) fixation

    Device: Protack™

Interventions

  • DeviceReliaTack™

    Absorbable tack (ReliaTack™) to fixate Symbotex™ composite mesh in the elective repair of incisional hernia.

  • DeviceProtack™

    Non-absorbable tack (Protack™) to fixate Symbotex™ composite mesh in the elective repair of incisional hernia.

05

What researchers measure

Primary outcomes

  1. Pain score

    Pain Score at rest and activity at day 30 recorded using visual analogue pain score (VAS) (0-10cm).

    Time frame: 30 days

Secondary outcomes

  1. Visual analogue pain score (VAS).

    Visual analogue pain score (VAS) pain score at days 1, 5-7 3 months and 1 year post-operative. A preoperative VAS score will also be recorded.

    Time frame: Day 1, days 5-7, 3 months, 1 year.

  2. Seroma formation.

    Seroma formation (no fixed time point) (a seroma will be defined as any clinically apparent fluid collection at the site of mesh placement).

    Time frame: Days 1, 6, 30, 3 months and 1 year post-operation.

  3. Postoperative hospital stay.

    The length of postoperative hospital stay.

    Time frame: Time from end of Surgery to patient discharge (up to end of study; 104 weeks).

  4. Time to return to normal daily activity.

    The time to return to normal daily activity.

    Time frame: From day of surgery to end of study (104 weeks).

  5. Wound infection.

    Any wound infection.

    Time frame: Days 1, 6, 30, 3 months and 1 year post-operation.

  6. Operating time.

    The time taken for the Operation - from start to finish.

    Time frame: Length of Operation.

  7. Mesh fixation time.

    Mesh fixation time after adhesions have been taken down and fascia closed.

    Time frame: Time during Operation.

  8. Hernia recurrence.

    Hernia recurrence at one year and at all time points.

    Time frame: Days 1, 6, 30, 3 months and 1 year post-operation.

  9. Health-related quality of life.

    Health-related quality of life - assessed using the Carolinas Comfort Score™ (which is specifically designed for hernia repair) (26) and Short Form 36™, at pre-operatively, 30 days and 1 year, (appendix K and SF-36).

    Time frame: 30 days and 1 year post-operation.

  10. Adverse Events.

    To capture any Adverse Events during the study duration.

    Time frame: Days 1, 6, 30, 3 months and 1 year post-operation.

06

Study locations

1 site
  • Manchester University NHS Foundation Trust
    Manchester, M13 9WL, United Kingdom
07

References and documents

Publications

  • Sheen AJ, Pilkington JJ, Baltatzis M, Tyurkylmaz A, Stathakis P, Jamdar S, Siriwardena AK. Comparison of Mesh Fixation Techniques in Elective Laparoscopic Repair of Incisional Hernia-ReliaTack v ProTack (TACKoMesh) - A double-blind randomised controlled trial. BMC Surg. 2018 Jul 11;18(1):46. doi: 10.1186/s12893-018-0378-3. PubMed 29996841 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03434301
Lead sponsor
Manchester University NHS Foundation Trust
Collaborators
Medtronic
Responsible party
Sponsor
First posted
Feb 15, 2018
Start date
Jul 20, 2017
Primary completion
Sep 22, 2020
Completion
Sep 22, 2020
Last update
Dec 7, 2021

Study contacts

Aali J Sheen
principal investigator · Manchester University NHS Foundation Trust

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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