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Sponsored by: |
University Hospital Inselspital, Berne |
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Information provided by: | University Hospital Inselspital, Berne |
ClinicalTrials.gov Identifier: | NCT00793286 |
Repair of inguinal hernia is the most common operation of the general surgeon. In recent years, it was recognized that chronic postoperative pain is as important for postoperative outcome as recurrent hernia. The incidence of pain or discomfort ranges up to 60% of operated patients. Despite the fact that laparoscopic hernia repair has been shown to reduce postoperative pain compared to open hernia repair, up to 5% of patients suffer from persistent discomfort. During that operation the mesh is either fixed using a stapler or tissue adhesive glue. With the current study we compare postoperative pain between patients undergoing laparoscopic inguinal hernia repair with either mesh fixation using a stapler or tissue adhesive. The use of von Frey monofilaments allows to describe pain with a high sensitivity.
Condition | Intervention |
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Inguinal Hernia Recurrence Pain |
Procedure: Mesh fixation by staples Procedure: Mesh fixation by glue |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Single Blind (Subject), Parallel Assignment, Efficacy Study |
Official Title: | Stapler Versus Glue for Laparoscopic Groin Hernia Repair |
Enrollment: | 80 |
Study Start Date: | August 2004 |
Study Completion Date: | October 2008 |
Primary Completion Date: | October 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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A
Mesh fixation by staples
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Procedure: Mesh fixation by staples
Mesh fixation by staples
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B
Mesh fixation by glue
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Procedure: Mesh fixation by glue
Mesh fixation by glue
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Despite the fact that laparoscopic hernia repair has been shown to reduce postoperative pain compared to open hernia repair, up to 5% of patients suffer from persistent discomfort. During that operation the mesh is either fixed using a stapler or tissue adhesive glue. With the current study we compare postoperative pain between patients undergoing laparoscopic inguinal hernia repair with either mesh fixation using a stapler or tissue adhesive. The use of von Frey monofilaments allows to describe pain with a high sensitivity.
To perform a prospective randomized trial comparing pain after inguinal hernia repair using either fixation with stapler or histoacryl.
The standard TAPP procedure is performed under general anesthesia. Patients receive a single shot antibiotic prophylaxis, using Amoxicillin/Clavulanic Acids. Operations are performed by resident surgeons under supervision, consultants or senior consultants. After hernial sac dissection and retraction, preperitoneal fat is removed bluntly and Cooper's ligament is identified. A Vypro II ® (Ethicon ®) prosthetic mesh, 10x15 cm, is placed and fixed depending on randomization with either 5 mm Protack TM (Autosuture TM) or Glubran ® 2 (G.E.M., Viareggio, Italy). Randomization is performed in permutated block of 20 using sealed envelopes. Where tissue glue is used, meshs are additionally fixed caudally and laterocaudally. Peritoneal closure over the mesh is performed using resorptive sutures. Glubran ® 2 is a cyanoacrylate tissue adhesive. Follow up assessment: The use of analgesics in the postoperative period is standardized using paracetamol and morphine derivates. Following discharge patients are liberated of physical restrictions. Patient follow-up will be performed after 6 weeks, 6 and 12 months postoperatively. Patients are advised to mention pain in the operated groin area. In addition the Visual Analogue Scale is used to evaluate pain intensity.Statistical comparison is done using Mann-Whitney Test and Chi square Test (significance p < 0,05).
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Switzerland | |
Dep. of Visceral and Transplantsurgery, Bern University Hospital | |
Bern, Switzerland, 3010 |
Principal Investigator: | Guido Beldi, MD | Dep. of Visceral and Transplantsurgery, Bern University Hospital |
Responsible Party: | Dep. of Visceral and Transplantsurgery, Bern University Hospital ( Guido Beldi, MD ) |
Study ID Numbers: | KEK_89_04 |
Study First Received: | November 18, 2008 |
Last Updated: | November 21, 2008 |
ClinicalTrials.gov Identifier: | NCT00793286 |
Health Authority: | Switzerland: Independent Local Research Ethic Commission (Ethikkommission) |
inguinal hernia laparoscopy mesh |
Pathological Conditions, Anatomical Hernia Hernia, Abdominal |
Pain Hernia, Inguinal Recurrence |
Disease Attributes Pathologic Processes |