Laparoscopic Ventral Hernia Repair with Routine Defect Closure Using Su2ura® Approximation Device

Ventral Hernia

hernia, primary, ventral, laparoscopy, umbilical

Study includes 5 visits: Screening, Baseline/Surgery, and 14 days, 3 months, 12months Follow-Ups post-surgery. The actual point of enrollment for each subject is considered the day of surgery. Total study duration is up to 12 months post-surgery. Surgery will be performed under general anesthesia. Standard antibiotic prophylaxis will be administered 30 min prior to skin incision. A surgical assistant will be selected by the PI from the surgical staff of the department. The procedure will involve placement of laparoscopic ports, reduction of the hernia sac, closure of the defect with the Su2ura® approximation device and fixation of mesh with tacks over the closed defect in an IPOM fashion. Based on surgeon consideration, primary umbilical hernia defects under 2 cm will be repaired with or without mesh. Study follow-up visits will take place 14 days, 3 months and 12 months post-surgery.

This study will be performed in accordance with the design and specific provisions of this protocol, in accordance with the ethical principles that have their origin in the Declaration of Helsinki, that are consistent with Good Clinical Practice (GCP), Title 21 of the Code of Federal Regulations (21 CFR), part 812 (Investigational Device Exemptions), and the applicable regulatory requirements. The study is a prospective, multi-center, open study, to evaluate the efficacy and safety of the Su2ura® approximation device. An abdominal hernia emerges through a preformed or acquired defect of the abdominal wall. The defect may be congenital (primary), acquired as a result of wear and tear (primary), or result from surgery or trauma, where failure of the abdominal wall to heal produces an incisional (non-primary) hernia. Examples of abdominal hernia include epigastric, umbilical and inguinal hernia. Patients may be asymptomatic or complain of a lump or pain. These patients are offered elective surgery. Patients may also present with complications necessitating emergency repair with or without additional resection of compromised viscera. Ventral hernias are very common and do present a challenge because of the risk of recurrence. Besides the surgeon, these hernias are ideally managed by a dietitian, nurse, and a physical therapist. Patient education has been a very popular topic in literature and hospital settings. Giving patients literature and discussing outcomes with instructions on multiple aspects throughout their encounters has shown to be very effective. The Su2ura Approximation Device is designed to deploy anchors threaded with stiches to facilitate tissue approximation by eliminating the need for the passing of a needle from one side of the tissue to the other as performed in traditional suturing. Utilizing the anchor feature allows a single action placement of a suture. The principal investigator from each medical center participated in an appropriate training program. This training included the surgery procedure in an animal. The Principal investigators will train the sub investigators in this procedure. The sponsor will also provide training on the laparoscopic simulator to the principal investigators. A total of 60 patients will be recruited to the study. Patients with a primary umbilical hernia under 2 cm will be recruited to the study and the hernia will be repaired with or without mesh according to the PI's decision. Eligible patients with a primary or secondary ventral hernia, desiring an elective surgical repair, who amply the inclusion/Exclusion criteria will be offered to participate in the study. Study includes 5 visits: Screening, Baseline/Surgery, and 14 days, 3 months, 12months Follow-Ups post-surgery. The actual point of enrollment for each subject is considered the day of surgery. Total study duration is up to 12months post-surgery.

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