Fibrin Sealant Spray Versus Mechanical Stapling in Laparoscopic Totally Extraperitoneal Hernioplasty
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Purpose
Laparoscopic totally extraperitoneal hernioplasty (TEP) is one of the treatment options for the repair of primary unilateral inguinal hernia. Previous studies showed that patients underwent TEP have less post-operative pain and earlier return to normal activities. However, chronic pain is still a major issue affecting quality of life after TEP with a reported incidence of 9.2-22.5%. Mechanical stapling is the most commonly used method of mesh fixation to prevent mesh migration but nerve entrapment by staples causing intractable pain had been reported. Recently several clinical trials showed that mesh fixation with fibrin sealant (FS) in TEP resulted in less chronic pain but increased incidence of seroma. A spraying device for application of FS laparoscopically is now available which can achieve mesh fixation by using fewer amounts of FS.
In this study, the investigators aim to compare the effectiveness of using fibrin spray for mesh fixation in reducing chronic pain after TEP. The investigators performed a randomized controlled trial by allocating patients in two study arm in random manner. The treatment group will have the mesh fixed by fibrin sealant spray, whereas the control group will have conventional mechanical staples for fixation. Operative procedures and post-operative management for the 2 groups will be identical. They will be follow-up at 1-month and 6-month after operation to evaluate the operative results and the incidence of chronic pain. Any complications related to the mesh and operation will also be recorded.
| Condition | Intervention | Phase |
|---|---|---|
|
Hernia |
Device: Fibrin sealant spray Device: Mechanical stapling |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | Randomized Prospective Trial of Fibrin Sealant Spray Versus Mechanical Stapling in Laparoscopic Totally Extraperitoneal Hernioplasty |
- Incidence of chronic pain [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Severity of acute pain [ Time Frame: 1 week ] [ Designated as safety issue: No ]
- Morbidities [ Time Frame: 30 day ] [ Designated as safety issue: Yes ]
- Recurrence rate [ Time Frame: 6 month ] [ Designated as safety issue: No ]
- Quality of life assessment [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Enrollment: | 129 |
| Study Start Date: | June 2007 |
| Study Completion Date: | December 2011 |
| Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Mechanical stapling |
Device: Mechanical stapling
Fixation of mesh would be performed using mechanical staplers
|
| Active Comparator: Fibrin sealant spray |
Device: Fibrin sealant spray
Fixation of mesh would be performed using fibrin sealant spray applied with a laparoscopic spray catheter
|
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Consecutive male patients aged between 18 to 70 years with reducible unilateral inguinal hernia undergoing day-case TEP under general anaesthesia will be considered eligible.
Exclusion Criteria:
- Bilateral hernia, recurrent hernia, partially reducible or strangulated hernia, large inguinal-scrotal hernia, previous abdominal incision (including previous contralateral hernia repair), peripheral neuropathy, coagulopathy or taking anticoagulation drugs, end-stage renal failure, cirrhosis, impaired cognitive function and those not consent to study.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Anthony Teoh, Honorary Assistant Professor, Chinese University of Hong Kong |
| ClinicalTrials.gov Identifier: | NCT01727050 History of Changes |
| Other Study ID Numbers: | FSMSLH |
| Study First Received: | November 12, 2012 |
| Last Updated: | November 16, 2012 |
| Health Authority: | Joint Chinese University of Hong Kong - New Territories East Cluster Clinical Research Ethics Committee (CREC): Hong Kong |
Additional relevant MeSH terms:
|
Hernia Pathological Conditions, Anatomical Fibrin Tissue Adhesive Hemostatics |
Coagulants Hematologic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 21, 2013