Obesity, Uncomplicated Ventral Incisional Hernia
Conditions
Keywords
IPOM Plus,, incisional Hernia, Ventral Hernia, Obesity
Brief summary
The aim of this study is to evaluate safety and effectiveness of a hybrid mesh (GORE® SYNECOR Intraperitoneal Biomaterial) in patients with a BMI of 30 kg/m2 or more undergoing laparoscopic ventral hernia repair (LVHR) with intraperitoneal position of the mesh.
Detailed description
A prospective Italian multicenter observational trial will be conducted in 8 different Italian centers to compare the effectiveness and feasibility of treatment of Incisional Hernia with GORE® SYNECOR Intraperitoneal Biomaterial mesh in patients with BMI \>30 kg/m2. This study was reviewed and approved by the local regional Ethics Committee. The study adhered to the CONSORT guidelines in reporting this trial's results
Interventions
DEVICEIntraperitoneal Onlay Mesh positioning Plus
Intraperitoneal Onlay Mesh (IPOM) Plus with closure of the hernia defect will be performed according to the common recommendations. The closure of the wall defect will be decided according to the surgeon evaluations: hernia size and choice of technique will be recorded in the database. The mesh will have an overlap of at least 5 cm on all sides of the defect. Dimension of the mesh will be sized to overlap the hernia orifice by at least five centimetres and placed in the intraperitoneal position. Using non-articulating laparoscopic fixation devices, 5.1-mm non-absorbable or absorbable tacks will be then positioned around the circumference of the prosthesis in a 3-row manner or 2-row manner based on the intraoperative findings, the patient's specific situation and the operating surgeon's decision.
Sponsors
Azienda Sanitaria Locale Napoli 2 Nord
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \> 18 years * Clean wounds * Informed consent * Patients affected by Incisional and Ventral Hernia * Elective surgery * Hernia size between 3 e 7 cm * BMI \> 30 kg/m2
Exclusion criteria
* age \< 18 years; * Life expectancy \< 24 months (as estimated by the operating surgeon), - * Pregnancy * Immunosuppressant therapy within 2 weeks before surgery * Clean-contaminated and contaminated, dirty wounds * Cirrhosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Incisional Hernia at Clinical examination | Patients are postoperatively examined at 1 months. | Clinical examination: Incisional Hernia is clinically defined as any visible or palpable ''blowout'' in site of incisional hernia treated |
| Rate of Incisional Hernia at ultrasonographic examination | Patients are postoperatively examined at 1 months. | An abdominal ultrasonography with the patient lying prone, will be performed in in all patients (symptomatic or asymptomatic) providing any valuable information about Hernia Recurrence onset. Valsalva maneuver will be performed during the ultrasonography scan. Size and location of all imaging detected Hernia Recurrence will be recorded, as well as any other patient's complaint. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients affected by organ space infections | Within 30 days postoperatively | Organ space infections according to Clavien-Dindo criteria |
| Number of patients affected by Superficial surgical site infections | Within 30 days postoperatively | Superficial infections according to Clavien-Dindo criteria |
| Postoperative pain | Postoperative pain will be recorded according to visual analogue scale Visual Analogue Scale at 1 month. | Postoperative pain will be recorded according to the Visual Analogue Scale (VAS). The Visual Analogue Scale (VAS) measures pain intensity. The Visual Analogue Scale consists of a 10cm line, with two end points representing 0 ('no pain') and 10 ('pain as bad as it could possibly be'). |
| Number of patients affected by Surgical Site Occurence | Within 30 days postoperatively | Surgical Site Occurence Reported according to the Ventral Hernia Working Group (VHWG) definitions |
| Number of patients affected by Deep surgical site infections | Within 30 days postoperatively | Deep surgical site infections according to Clavien-Dindo criteria |
Countries
Italy
Contacts
Primary ContactFrancesco Pizza, MD, PhD
Backup ContactDario D'antonio, Md
Outcome results
None listed