AzTrials
AzTrials

Inguinal HerniaSELFITACNCT03564535

Comparison of Self Fixating Mesh to Mesh Fixation With Metallic Tacks in Laparoscopic Inguinal Hernia Repair

A study testing Self fixating group and Tacker fixation group in people with Inguinal Hernia and Adult, run by All India Institute of Medical Sciences, Bhubaneswar at 1 site in India.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

This study compares the use of self-fixating mesh to mesh fixation with tackers in the management of inguinal hernia by laparoscopic method. Half of the participants in the study will be treated using self-fixating mesh, while the other half will be treated using conventional mesh fixed with tackers. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Inguinal Hernia, Adult
What is being tested?
Self fixating group and Tacker fixation group
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
112 participants
Where
1 siteIndia
Study dates
18 Apr 2018to Mar 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Unilateral inguinal hernia
  • Age 18-80years
  • American Society of Anesthesiologists (ASA) Grade 1 or 2

Who cannot join

  • Patient unfit for general anesthesia or laparoscopic surgery
  • Large scrotal hernias
  • Irreducible hernias
  • Morbid obesity
  • Previous pelvic surgery
  • Coagulopathy
Show all 12Show fewer
  • Those who cannot understand the VAS score
  • Those who did not agree to participate in the study
  • Gastritis
  • Gastroesophageal reflux disease
  • Liver dysfunction
  • kidney dysfunction

Trial locations and contacts

1 site in 1 country.

India1 site
  • Tushar S Mishra

    Bhubaneswar, Odisha, 751019

Other trials in India

About this study

Official title: Comparison of Mesh Fixation With Tackers to Use of Self Fixating Mesh in Total Extra Peritoneal Inguinal Hernia Repair: A Double Blinded Randomized Controlled Trial

This study compares the use of self-fixating mesh to mesh fixation with tackers in the management of inguinal hernia by laparoscopic method. Half of the participants in the study will be treated using self-fixating mesh, while the other half will be treated using conventional mesh fixed with tackers.

Read the detailed description

Conventional tacker mesh fixation group Patients will be undergoing mesh fixation with non-absorbable tacks. Monofilament polyester mesh of size 15*11cm will be used. The tacks would be used such that they avoid bony prominences and vascular and neural structures. One tack will put at the Cooper's ligament and another applied laterally superior to the iliopubic tract in the anterior abdominal wall. In any patient, the maximum number of tacks applied will not exceed four. Preperitoneal space will be deflated under direct visualization after the mesh is placed. Hernia sac and any cord lipoma will be placed behind the mesh. During the deflation process, repositioning of the peritoneal sac on the mesh, in particular the dorsal edge of the latter would be carefully performed to avoid displacement or folding of the mesh.

Self-fixating mesh group In this group,Monofilament polyester mesh with polylactic acid (PLA) microgrips of size 15*11 will be used. It is an isoelastic large-pore knitted fabric with a density of 73g/m2 at implantation and 38g/m2 after microgrips absorption which will be at 18 months. The resorbable micro grips provide immediate adherence to surrounding muscle and adipose tissue during the initial days post hernia surgery, serving as an alternate method of fixation to traditional sutures, tacks, staples, or fibrin sealants. No additional tacks, staples, sutures, or fibrin sealant is used

Being tested
Self fixating group, Tacker fixation group
Keywords
Adult, Inguinal hernia, Inflammatory, Surgical Mesh, Laparoscopy/Methods, Postoperative pain, Recurrence, Randomized Controlled Trials, Double-Blind Method, Pain, Chronic pain, Seroma, Total extraperitoneal repair, Tacker, Mesh fixation, Self gripping
Medical subject headings
Hernia, Inguinal, Pain, Postoperative, Recurrence, Pain, Chronic Pain, Seroma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Self fixating groupDevice

    Also called Monofilament polyester mesh with polylactic acid microgrips

    Monofilament polyester mesh with polylactic acid (PLA) microgrips of size 11*15 will be used. It is an isoelastic large-pore knitted fabric with a density of 73g/m2 at implantation and 38g/m2 after microgrips absorption which will be at 18 months. The resorbable micro grips provide immediate adherence to surrounding muscle and adipose tissue during the initial days post hernia surgery, serving as an alternate method of fixation to traditional sutures, tacks, staples, or fibrin sealants. No additional tacks, staples, sutures, or fibrin sealant will be used.

  • Tacker fixation groupDevice

    Also called Polyester mesh with tack fixation

    Patients will be undergoing polyester mesh fixation with non-absorbable tacks. The tacks would be used such that they avoid bony prominences and vascular and neural structures. One or two tacks will be put at the Cooper's ligament and another applied laterally superior to the iliopubic tract in the anterior abdominal wall. In any patient, the maximum number of tacks applied will not exceed three.

Study groups in NCT03564535
Study groupRoleWhat they receive
SELF FIXATING GROUPExperimentalMonofilament polyester mesh with polylactic acid (PLA) microgrips of size 11*15 will be used. It is an isoelastic large-pore knitted fabric with a density of 73g/m2 at implantation and 38g/m2 after microgrips absorption which will be at 18 months. The resorbable micro grips provide immediate adherence to surrounding muscle and adipose tissue during the initial days post hernia surgery, serving as an alternate method of fixation to traditional sutures, tacks, staples, or fibrin sealants. No additional tacks, staples, sutures, or fibrin sealant will be used.
Receives: Device: Self fixating group
TACKER FIXATION GROUPActive comparatorPatients will be undergoing mesh fixation with non-absorbable tacks. The tacks would be used such that they avoid bony prominences and vascular and neural structures. One or two tacks will be put at the Cooper's ligament and another applied laterally superior to the iliopubic tract in the anterior abdominal wall. In any patient, the maximum number of tacks applied will not exceed three.
Receives: Device: Tacker fixation group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in post operative pain

    Postoperative pain will be evaluated using Visual Analogue Scale (0 TO 10) at follow up at ward, Out Patient Department/patient's pain diary/by telephonic call/by e-mail. In the first 6hours, if the VAS score >4 Inj.Paracetamol 1gm I V will be given, if the VAS score >4 after 30min of previous dose, inj diclofenac 75mg iv will be given, if VAS score is still >4 inj.Tramadol 100mg will be given. After 6 hours pain killers will be given in the same order and same dose orally as a tablet depending upon the requirement and pain score. Highest pain score at any given point of time and average pain score will be calculated.

    Measured: 1 hour, 6 hours,12 hours, 24 hours, 7 days, 1 month and 3 months post surgery

Secondary outcomes (10)
  1. Mesh displacement

    Meshes will be marked with three 5-mm surgical clips at its medial inferior, medial superior and lateral inferior corners. Pelvic x ray will be done on post operative day 1 and at the end of 1 month to look for any displacement.

    Measured: 24 hours and 1 month post surgery

  2. Inflammatory markers

    On the day of surgery, preoperative venous blood samples (baseline) will be withdrawn and assayed for C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and total white blood cell count (WBC). Venous blood samples will be obtained 48 h post-surgery and assayed for CRP and WBC. ESR will be checked at 3 months postoperatively. Acute surgical trauma corresponding to postoperative acute pain will be measured using CRP and WBC, while chronic pain will be measured with ESR.

    Measured: On the day of surgery (pre op), 48 hours post surgery, 3 months post surgery

  3. Post operative complications

    Various known post operative complications will be looked for such as

    1. Post-operative urinary retention
    2. Seroma
    3. Hematoma
    4. Early recurrence
    5. Wound infection
    6. Cord edema
    7. Testicular atrophy

    Measured: 6 hours, 24 hours, 48 hours, 7 days, 1 month, 3 months post surgery

  4. Operative time

    Time required to complete the surgery i.e from incision time to closure time.

    Measured: Time of skin incision to time of skin closure

  5. Achieving criteria of fitness for discharge

    Discharge criteria includes

    1. Pain adequately controlled by oral analgesics (VAS Score <4)
    2. Ambulation without help
    3. Absence of post operative complications requiring surgical interventions

    Measured: Time of skin closure to time of discharge which will be approximately 2 days.

  6. Resumption to normal activities

    Return to normal activity will be assessed by recording the time taken by the patient to get in and out of bed and ambulate without help.

    Measured: Immediate post operative period.

  7. Total cost towards the mesh and its fixation

    Total cost involved in the procedure would be measured in both the arms.

    Measured: Immediate post operative period.

  8. Quality of life using Carolinas Comfort Scale

    Quality of life will be measured using Carolinas Comfort Scale (CCS), a validated post hernia quality of life and pain assessment tool developed by physician and researchers from Carolina laparoscopic and advanced surgery programme (CLASP), to monitor quality of life in patients undergoing hernia repair. The CCS is a 23-item, Likert type questionnaire that measures, on a scale of 0 to 5, severity of pain, sensation and movement limitations from the mesh.

    Carolinas Comfort Scale questionnaire (maximum: 115 points)

    Sensation of mesh, pain and movement limitations need to be graded on a scale of 0 to 5 or as not applicable

    1. While laying down,
    2. While bending over,
    3. While sitting up, 4.While performing activities of daily living (getting out of bed, bathing, getting dressed),

    5 When coughing or deep breathing, 6 When walking or standing, 7 When walking up or down stairs, 8 When exercising (other than work-related), Total CCS score: ………

    Measured: 6 hours, 24 hours, day 7 , 1 month and 3 month post surgery.

  9. Mesh deployment time

    Total time required from insertion of mesh into trocar till complete deployment is done. Mesh deployment satisfaction rate will also be noted.

    Measured: Time from insertion of mesh into trocar till complete deployment is done.

  10. Intra operative complications

    Various intra operative complications will be recorded such as

    1. Bladder injury
    2. Vas Deferens injury
    3. Iliac vein injury
    4. Pneumoperitoneum
    5. Dropping down/Injury of inferior epigastric artery
    6. Bowel injury

    Measured: Intra operatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jun 2018
  2. Study start18 Apr 2018
  3. Primary completionMar 2021 (estimated)
  4. Study completionMar 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients of uncomplicated inguinal hernia presenting to the outpatient department of AIIMS, Bhubaneswar will be recruited to the study. They would be put either in the conventional tacker group or self-fixating mesh group based on the sealed envelope which will be revealed once the patient is intubated. Random allocation done using random allocation software. Surgeries would be performed by single surgery team experienced in laparoscopic hernia repair.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
112 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03564535
Sponsor's protocol ID
T/IM-NF/Surg/17/36
Acronym
SELFITAC
Status last verified
Feb 2021
First submitted
10 Apr 2018
Last updated
3 Feb 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Liew W, Wai YY, Kosai NR, Gendeh HS. Tackers versus glue mesh fixation: an objective assessment of postoperative acute and chronic pain using inflammatory markers. Hernia. 2017 Aug;21(4):549-554. doi: 10.1007/s10029-017-1611-1. Epub 2017 Apr 17.

    PubMed 28417279
  • Buyukasik K, Ari A, Akce B, Tatar C, Segmen O, Bektas H. Comparison of mesh fixation and non-fixation in laparoscopic totally extraperitoneal inguinal hernia repair. Hernia. 2017 Aug;21(4):543-548. doi: 10.1007/s10029-017-1590-2. Epub 2017 Feb 18.

    PubMed 28214943
  • Garg P, Rajagopal M, Varghese V, Ismail M. Laparoscopic total extraperitoneal inguinal hernia repair with nonfixation of the mesh for 1,692 hernias. Surg Endosc. 2009 Jun;23(6):1241-5. doi: 10.1007/s00464-008-0137-0. Epub 2008 Sep 24.

    PubMed 18813990
  • Bresnahan E, Bates A, Wu A, Reiner M, Jacob B. The use of self-gripping (Progrip) mesh during laparoscopic total extraperitoneal (TEP) inguinal hernia repair: a prospective feasibility and long-term outcomes study. Surg Endosc. 2015 Sep;29(9):2690-6. doi: 10.1007/s00464-014-3991-y. Epub 2014 Dec 18.

    PubMed 25519425
  • Teng YJ, Pan SM, Liu YL, Yang KH, Zhang YC, Tian JH, Han JX. A meta-analysis of randomized controlled trials of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair. Surg Endosc. 2011 Sep;25(9):2849-58. doi: 10.1007/s00464-011-1668-3. Epub 2011 Apr 13.

    PubMed 21487873

Questions about this trial

What is this clinical trial studying?

A study testing Self fixating group and Tacker fixation group in people with Inguinal Hernia and Adult, run by All India Institute of Medical Sciences, Bhubaneswar at 1 site in India.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 3 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in India. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in post operative pain (time frame: 1 hour, 6 hours,12 hours, 24 hours, 7 days, 1 month and 3 months post surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03564535, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Feb 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in