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CompletedNCT05906017Updated May 14, 2026

Open Versus Robotic-assisted Ventral Hernia Repair, Short and Long-term Outcome

An interventional study of Open Hernia surgery and Robotic Hernia surgery in Abdominal Hernia, sponsored by University of Southern Denmark. Completed at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-14.

Sponsored by University of Southern Denmark · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
56
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

In this randomized clinical trial, the investigators will compare the conventional open repair for hernia in the anterior abdominal wall with the robotic-assisted approach. 60 patients with midline abdominal wall defects will be randomized to either open or robotic-assisted surgery. The investigators will examine short and long-term complications through follow-up with clinical assessment as well as patient-reported outcome measures including pain, cosmetic appearance, and overall patient satisfaction. Furthermore, the investigators will study the difference in surgical stress response between the two methods measured from a variety of different biomarkers before and after the operation. A cost-effective analysis will be conducted for the robotic and open procedure.

Read the detailed description

Ventral hernias occur in up to 25% of the population. They are diverse in severity ranging from small umbilical hernias to large abdominal wall defects that may result in loss of domain. Approximately one-third are incisional hernias. Incisional hernias are usually more complex due to complications from previous surgery. The procedure may be complicated as a result of intraabdominal bowel adhesions and adhesions within the hernial sac. These factors cause discomfort and may complicate the repair. Ventral hernias may be repaired either through a minimally invasive laparoscopic procedure or an open approach. The laparoscopic repair was introduced in the 1990s and in 2003 the first robotic-assisted procedure was described in a porcine model. In 2012 the first series of robotic repairs were reported in humans. Due to the superior flexibility of the robotic instruments, there is a substantial interest in harnessing the advantages of the robotic platform. Because robotic repair differs in several technical aspects from the open approach, it is important to determine whether the short and long-term results differ between the two procedures. Furthermore, it remains unresolved whether the robotic procedure is able to provide comparable outcomes to the open repair when assessed for quality-of-life outcome measures. These questions are important to address in order to determine the most appropriate surgical options for individual patients.

02

Conditions studied

  • Abdominal Hernia

Keywords

  • Da Vinci
  • Robot
  • Umbilical hernia
  • Ventral hernia
  • Epigastric hernia
  • Hernia repair
  • Laparotomy
03

Who can participate

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

Inclusion criteria

  • Age≥18
  • ASA 1-3
  • Clinical and radiologic diagnosis of midline ventral hernia
  • Eligible to surgery according to a preoperative anaesthetic assessment
  • Informed consent
  • Able to understand written and oral Danish language

Exclusion criteria

Exclusion Criteria:

  • Incarcerated ventral hernia requiring emergency surgery
  • Pregnancy
  • Patients with chronic pain due to arthritis, migraine or other illness requiring regular intake of analgesics (paracetamol, NSAID, opiates etc).
  • Current cancer diagnosis
  • History of psychiatric or addictive disorder that prevents the patient from participating in the trial
  • Co-existing inflammatory disease
  • Co-existing immunological disease that requires medication of any kind
  • BMI >40 kg/m2
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
56 participants (actual)

Study arms

  • Active comparator
    Open repair

    Open ventral hernia repair

    Procedure: Open Hernia surgery

  • Experimental
    Robotic-assisted repair

    Robotic-assisted ventral hernia repair

    Procedure: Robotic Hernia surgery

Interventions

  • ProcedureOpen Hernia surgery

    midline ventral hernia repair - open

  • ProcedureRobotic Hernia surgery

    midline ventral hernia repair - robotic

05

What researchers measure

Primary outcomes

  1. Length of stay (LOS)

    The primary outcome measure will be assessed by reviewing the electronic patient journal system. The day of the procedure will be recorded as day 0

    Time frame: Up until 3 months

Secondary outcomes

  1. Operating time

    Measured in minutes

    Time frame: Time from first incision to wound closure

  2. Change in Surgical stress response (CRP)

    The degree of systemic inflammatory response expressed by C- reactive protein in serum

    Time frame: measured at baseline preoperatively, 30 minutes after extubation, 120 minutes after extubation and on day 1 and 3.

  3. Hernia defect size

    Hernia defect size measured in mm either on CT scan or intraoperative.

    Time frame: Measured preoperatively

  4. Intraoperative need of blood transfusion

    The amount of blood transfused during surgery measured in mL

    Time frame: From first incision until last suture has been placed

  5. Change in surgical stress response (Interleukins)

    The degree of systemic inflammatory response expressed by cytokine levels in serum. All measurements will consist of weight/volume ratio (eg. CRP mg/L and IL-6 pg/mL)

    Time frame: Measured at baseline preoperatively and up until 120 minutes after extubation on day 1 and 3.

  6. Treatment cost

    Cost analysis of the two types of treatment

    Time frame: From inclusion until 6 months postoperatively

  7. Change in satisfaction and quality of life

    Satisfaction and quality of life were measured preoperatively at the outpatient clinic using the "abdominal hernia questionnaire" (AHQ) translated into Danish. The AHQ has 4 possible answers (All of the time, Most of the time, Some of the time, None the time OR Strongly disagree, Somewhat disagree, Somewhat agree, Strongly agree OR Very unsatisfied, Somewhat dissatisfied, Somewhat satisfied, Very satisfied)

    Time frame: [Time Frame: From inclusion until 6 months after operation.]

06

Study locations

1 site
  • Sygehus Sønderjylland
    Aabenraa, Southern Denmark 6200, Denmark
07

References and documents

Publications

  • Nielsen KA, Valorenzos A, Tsigka E, Frandsen CH, Helligso P, Petersen SR, Ellebaek MB, Nielsen MF. Open versus robotic-assisted repair of midline ventral hernias with defect width 2-8 cm - a randomized clinical trial (OVER). Hernia. 2026 Apr 2;30(1):155. doi: 10.1007/s10029-026-03617-7. PubMed 41925930 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT05906017
Lead sponsor
University of Southern Denmark
Responsible party
Sponsor
First posted
Jun 15, 2023
Start date
May 15, 2023
Primary completion
Apr 25, 2025
Completion
Oct 25, 2025
Last update
May 14, 2026

Study contacts

Michael Festersen Nielsen
study director · Hospital of Southern Denmark - Aabenraa

Oversight

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

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