Robotic Versus Open Comparison in the Surgical Treatment of Wide Abdominal Wall Hernias (ROCSTAR)
Primary Purpose
Ventral Incisional Hernia
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Component separation (transversus abdominis release)
Sponsored by
About this trial
This is an interventional treatment trial for Ventral Incisional Hernia
Eligibility Criteria
Inclusion Criteria:
- All patients with a ventral incisional hernia of more than 8 centimeters in width
Exclusion Criteria:
- Emergency surgery
- Pregnancy
- Age<18
- Incisional hernia repair after open abdomen or enterocutaneous fistula
- Active wound infection
- Previous anterior or posterior component separation
- Absence of a signed informed consent
- Patients unable to give informed consent or complete the quality-of-life assessment (due to language barriers or intellectual capacity)
- Primary ventral hernias
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Robotic-assisted repair of wide ventral incisional hernia
Open repair of wide ventral incisional hernia
Arm Description
Robotic
Open
Outcomes
Primary Outcome Measures
Length of postoperative hospital stay
Length of postoperative hospital stay
Secondary Outcome Measures
Skin-to-skin operative time
Skin-to-skin operative time
Conversion rate
Conversion rate
Postoperative complication rate
Surgical site infection - surgical site occurrence - surgical site occurrence requiring procedural interventions
Readmission and reoperation rate
Readmission and reoperation rate
Post-anesthetic discharge scoring system
Minimum score is 0, maximum score is 12. The higher the score, the better the outcome.
Postoperative visual analogue scale pain score
Minimum score is 0, maximum score is 10. The higher the score, the worse the outcome.
Quality of Life Scoring
Minimum score is 0, maximum score is 90. The higher the score, the worse the outcome.
Body image score
Minimum score is 0, maximum score is 10. A higher score means a higher level of body image disturbance (worse outcome).
Hernia recurrence
Hernia recurrence
Reoperation for hernia recurrence or abdominal surgery not for hernia recurrence
Reoperation for hernia recurrence or abdominal surgery not for hernia recurrence
Full Information
NCT ID
NCT05575141
First Posted
April 2, 2022
Last Updated
October 8, 2022
Sponsor
Algemeen Ziekenhuis Maria Middelares
1. Study Identification
Unique Protocol Identification Number
NCT05575141
Brief Title
Robotic Versus Open Comparison in the Surgical Treatment of Wide Abdominal Wall Hernias
Acronym
ROCSTAR
Official Title
Robotic Versus Open Comparison in the Surgical Treatment of Wide Abdominal Wall Hernias: an Open-label Multicenter International Randomized Controlled Trial
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 1, 2023 (Anticipated)
Primary Completion Date
January 1, 2024 (Anticipated)
Study Completion Date
March 1, 2029 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Algemeen Ziekenhuis Maria Middelares
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
In the treatment of ventral incisional hernias, a mesh repair in the retromuscular plane is considered as the gold standard. To allow for adequate medialization of the fascial borders and a complete closure of the defect in case of large incisional hernias, component separation techniques are increasingly being used. When compared to anterior component separation, posterior component separation by transversus abdominis release (TAR) seems to decrease postoperative wound problems. While laparoscopic techniques pose significant difficulties to perform TAR minimally invasively (mainly due to ergonomic and technical reasons), these limitations seem to be overcome by robotic platforms. Initial retrospective patient series report on significantly shorter postoperative hospital stay and fewer complications after robotic transversus abdominis release (rTAR), when compared to open transversus abdominis release (oTAR). High-quality prospective evidence on rTAR is currently lacking.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ventral Incisional Hernia
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
An open-label multicenter international European randomized controlled trial
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Robotic-assisted repair of wide ventral incisional hernia
Arm Type
Active Comparator
Arm Description
Robotic
Arm Title
Open repair of wide ventral incisional hernia
Arm Type
Active Comparator
Arm Description
Open
Intervention Type
Procedure
Intervention Name(s)
Component separation (transversus abdominis release)
Intervention Description
Component separation by transversus abdominis release, to allow for adequate medialization of the fascial borders and a complete closure of the defect in case of large incisional hernias.
Primary Outcome Measure Information:
Title
Length of postoperative hospital stay
Description
Length of postoperative hospital stay
Time Frame
From date of operation until the date of discharge, assessed up to 20 days
Secondary Outcome Measure Information:
Title
Skin-to-skin operative time
Description
Skin-to-skin operative time
Time Frame
Per-operative (minutes)
Title
Conversion rate
Description
Conversion rate
Time Frame
Per-operative
Title
Postoperative complication rate
Description
Surgical site infection - surgical site occurrence - surgical site occurrence requiring procedural interventions
Time Frame
30 days
Title
Readmission and reoperation rate
Description
Readmission and reoperation rate
Time Frame
30 Days
Title
Post-anesthetic discharge scoring system
Description
Minimum score is 0, maximum score is 12. The higher the score, the better the outcome.
Time Frame
Immediately after the surgery
Title
Postoperative visual analogue scale pain score
Description
Minimum score is 0, maximum score is 10. The higher the score, the worse the outcome.
Time Frame
Immediately after the surgery
Title
Quality of Life Scoring
Description
Minimum score is 0, maximum score is 90. The higher the score, the worse the outcome.
Time Frame
Preoperatively, 30 days, 3 months, 12 months, 24 months, 60 months
Title
Body image score
Description
Minimum score is 0, maximum score is 10. A higher score means a higher level of body image disturbance (worse outcome).
Time Frame
Preoperatively, 30 days, 3 months, 12 months, 24 months, 60 months
Title
Hernia recurrence
Description
Hernia recurrence
Time Frame
3 Months, 12 months, 24 months, 60 months
Title
Reoperation for hernia recurrence or abdominal surgery not for hernia recurrence
Description
Reoperation for hernia recurrence or abdominal surgery not for hernia recurrence
Time Frame
3 Months, 12 months, 24 months, 60 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
- All patients with a ventral incisional hernia of more than 8 centimeters in width
Exclusion Criteria:
Emergency surgery
Pregnancy
Age<18
Incisional hernia repair after open abdomen or enterocutaneous fistula
Active wound infection
Previous anterior or posterior component separation
Absence of a signed informed consent
Patients unable to give informed consent or complete the quality-of-life assessment (due to language barriers or intellectual capacity)
Primary ventral hernias
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Maaike Vierstraete, MD
Phone
+3292467400
Email
maaikevierstraete@icloud.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Filip Muysoms, MD PhD
Organizational Affiliation
Clinical research center Maria Middelares
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Robotic Versus Open Comparison in the Surgical Treatment of Wide Abdominal Wall Hernias
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