Closing of the hernia defect during laparoscopic ventral hernia repair

ISRCTN ISRCTN51495042
DOI https://doi.org/10.1186/ISRCTN51495042
Secondary identifying numbers ML2
Submission date
15/02/2016
Registration date
22/04/2016
Last edited
03/01/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Digestive System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
A ventral hernia is a bulge of tissues through an opening (or defect) within the abdominal wall muscles. They can sometimes cause symptoms such as pain in the abdomen, outward bulging of skin or tissues, nausea and vomiting. This study is comparing two different ways of performing laparoscopic (keyhole) ventral hernia repair. The aim is to test the effect of closing the defect with a suture (stitches) before reinforcement using a mesh.

Who can participate?
Adults (over 18) with a ventral hernia which has not previously been repaired with a mesh.

What does the study involve?
Participants are randomly assigned to one of two groups. Group 1 has a laparoscopic ventral hernia repair with the defect sutured before using the mesh. Participants in group 2 have their mesh applied without closing of the defect with a suture. All participants are then assessed at 3 months and then again at 12 months for complications. They also have a CT scan at 12 months. Tissue samples (biopsies) are also taken from the skin, muscle Biopsy from skin, muscle and fascia (connective tissue) are taken and analysed.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Skellefteå hospital
Mora hospital
Ersta hospital
Enköping hospital (Sweden)

When is the study starting and how long is it expected to run for?
April 2015 to November 2021

Who is funding the study?
1. Västerbotten County Council
2. Visare Norr (cooperation northern counties)

Who is the main contact?
Mr Mikael Lindmark

Study website

Contact information

Mr Mikael Lindmark
Scientific

University Hospital of Umeå (Norrlands Universitetssjukhus)
Umeå
901 85
Sweden

Study information

Study designDouble-blinded randomized controlled multicenter trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Please use contact details to request a participant information sheet
Scientific titleProspective RandOmised Study of Endoscopic fascia Closure and long term Outcome
Study acronymPROSECO
Study objectivesSuture of hernia defect before application of mesh prothesis for laparoscopic ventral hernia repair improves the surgical outcome measured as "hernia site complications" (see primary outcome measures below).
Ethics approval(s)Regional ethics board Umeå (SE), 18/06/2015, ref: 2015-215-32M
Health condition(s) or problem(s) studiedVentral hernia
InterventionThe classic approach in laparoscopic ventral hernia repair is to bridge the hernia defect by reinforcement material. In open techniques, a long- established principle is to, when possible, recreate the anatomy during surgery by suturing of the defect. There is an emerging interest in closing the defect in laparoscopic surgery for ventral hernias before the prosthetic material is applied.

Participants are randomly assigned to one of two groups. They all have a laparoscopic ventral hernia repair, but with the following differences:
Group 1: Undergo suture of hernia defect before application of mesh
Group 2. Mesh is applied without closing of the defect

All participants are then assessed for hernia site complications that occur within 12 months including seroma, hematoma, bulging, mesh migration and infection.

All participants are then assessed for hernia site complications at clinical control after 3 and 12 months. All participants undergo CT scan at 12 months. Hernia site complications include seroma, hematoma, bulging, mesh migration and infection. Biopsy from skin, muscle and fascia are taken and collagen structure will analysed.
Intervention typeProcedure/Surgery
Primary outcome measureHernia site complications within twelve months. This includes recurrence of the hernia, sustained clinically significant seroma, and clinically significant and symptomatic pseudo hernia with sliding of the reinforcing material into the aneurysm sac after twelve months.
Secondary outcome measures1. Abdominal wall pain, assessed using the Ventral Hernia Pain Questionnaire, before surgery, 3 months after surgery and after 12 months
2. Surgical complications within three months of such as infection, and fistula
3. Operating time
4. Abdominal function measured by Biodex after 12 months
Overall study start date08/04/2015
Completion date01/11/2021

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants180
Total final enrolment192
Key inclusion criteria1. Age >18 years
2. Understand written information in Swedish
3. Primary or incisional hernia of the midline between 2 and 8 cm
Key exclusion criteria1. Recurrence after previous hernia surgery
2. Laparoscopy not feasible
Date of first enrolment18/11/2015
Date of final enrolment16/09/2020

Locations

Countries of recruitment

  • Sweden

Study participating centres

Skellefteå Hospital (Skellefteå lasarett)
931 41 Skellefteå
Sweden
Mora hospital (Mora lasarett)
792 51 Mora
Sweden
Ersta hospital
Stockholm
116 28
Sweden
Enköping hospital
Enköping
745 38
Sweden

Sponsor information

Västerbotten County Council
University/education

Landstingshuset
Köksvägen 11
Umeå
901 85
Sweden

ROR logo "ROR" https://ror.org/04xvhsp09

Funders

Funder type

Government

Visare Norr (cooperation northern counties)

No information available

Västerbotten Läns Landsting
Government organisation / Local government
Alternative name(s)
Västerbotten County Council
Location
Sweden

Results and Publications

Intention to publish date30/06/2023
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination plan
IPD sharing planThe dataset includes information making it possible to identify unique individuals, therefore in relation to their ethical statement and Swedish law the researchers have to handle it confidentially.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 30/12/2023 03/01/2024 Yes No

Editorial Notes

03/01/2024: Publication reference added.
13/12/2022: The intention to publish date was changed from 01/04/2023 to 30/06/2023.
15/11/2022: The intention to publish date has been changed from 30/11/2022 to 01/04/2023.
21/04/2022: The intention to publish date has been changed from 30/04/2022 to 30/11/2022.
18/05/2021: The following changes were made to the trial record:
1. The overall trial end date was changed from 01/05/2021 to 01/11/2021.
2. The intention to publish date was changed from 31/01/2022 to 30/04/2022.
16/10/2020: The following changes have been made:
1. The recruitment end date has been changed from 15/10/2020 to 16/09/2020.
2. The total final enrolment number has been added.
25/08/2020: The recruitment end date has been changed from 01/05/2020 to 15/10/2020.
24/08/2020: Recruitment for this study is no longer paused.
28/05/2020: Due to current public health guidance, recruitment for this study has been paused.
20/01/2020: IPD sharing statement added.
17/01/2020: The following changes were made to the trial record:
1. The recruitment end date was changed from 20/12/2019 to 01/05/2020.
2. The overall trial end date was changed from 20/12/2020 to 01/05/2021.
3. The intention to publish date was changed from 31/01/2021 to 31/01/2022.
18/10/2019: The intention to publish date has been changed from 08/04/2019 to 31/01/2021.
03/10/2019: The following changes were made to the trial record:
1. The overall end date was changed from 08/04/2018 to 20/12/2020.
2. The recruitment end date was changed from 08/04/2017 to 20/12/2019.
3. The trial participating centre "Sunderby hospital" was removed, "Ersta hospital" and "Enköping Hospital" were added.