Anchor for Robotic Sacrocolpopexy (ARiSe)

March 4, 2019 updated by: Kaiser Permanente

The Use of Anchor Versus Suturing for Attachment of Vaginal Mesh in Minimally Invasive Sacrocolpopexy

  1. PRIMARY OBJECTIVE: To assess the effect of absorbable anchor compared to suturing for mesh attachment to vagina in robotic assisted sacrocolpopexy on the length of surgery for this portion of the procedure.
  2. SECONDARY OBJECTIVES:

    i. To assess intraoperative and ii. postoperative complication rates, iii. Intraoperative 10 cm visual analog scale (VAS), to subjectively assess surgeon satisfaction with the technique iv. post-operative Pelvic Organ Prolapse Quantification (POPQ) evaluation for anatomic failure and v. a VAS of the vaginal walls overall appearance

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

By applying a commonly used surgical technique of absorbable anchors to a new surgery, Sacrocolpopexy (SCP), operative time may be decreased while providing similar patient outcomes. Absorbable anchors have been validated in mesh fixation during laparoscopic surgical repair of hernias. This technique potentially takes less time than traditional suturing, thus decreasing cost and morbidity of anesthesia. The investigators hypothesis proposes that for women undergoing SCP at a large managed care organization, participants receiving anchor suture staples to attach the mesh to the vagina compared to participants receiving standard treatment will require 50% shorter surgical time for the mesh attachment portion of the surgery. The investigators secondary hypothesis is for women undergoing SCP at a large managed care organization, participants receiving anchor suture staples to attach the mesh to the vagina compared to participants receiving standard treatment will have similar rates of intra-operative and post-operative complications and surgical failure. On VAS, patients will not have different appearance of the vaginal walls. Surgeons will report higher satisfaction with the anchor technique.

Study Type

Interventional

Enrollment (Actual)

53

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • California
      • San Diego, California, United States, 92110
        • Kaiser Permanent San Diego

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

21 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Age 21 or older
  • Diagnosis of POP, defined as the descent of one or more of four different anatomic structures, a)the uterus(cervix), b)the apex of the vagina (in those status post hysterectomy) c) the anterior vaginal wall, or d) the posterior vaginal wall. This is defined on exam as the POPQ points Ba, C, or Bp >0 cm beyond the hymen, uterine(cervix) descent into at least the lower half the vagina (defined as point c> -tvl/2) or post hysterectomy vault into the lower 2/3 of the vagina. Bothersome bulge symptoms as indicated on question 3 of the Pelvic Floor Disorder Inventory (PFDI-20) form relating to 'sensation of bulging' or something 'falling out'
  • Desire surgical treatment for POP with SCP
  • Available for up to 6 months of follow up
  • Not pregnant or desiring future pregnancy
  • Written informed consent is obtained.

Exclusion Criteria:

  • Known adverse reaction to synthetic mesh, or complications including but not limited to erosion, fistula, or abscess.
  • Cervical intraepithelial neoplasia (cervical intraepithelial neoplasia (CIN) 2, CIN3, or cancer)
  • Unresolved chronic pelvic pain
  • Prior abdominal or pelvic radiation
  • Contraindications to the surgical procedures including known horseshoe kidney, pelvic abscess or active diverticular abscess or diverticulitis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: QUADRUPLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Anchor
Anchor used for mesh attachment
Anchor technique for mesh attachment
ACTIVE_COMPARATOR: Suture
Suture used for mesh attachment
Suture technique for mesh attachment

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mesh Attachment Time
Time Frame: Assessed at one time point, during the participants surgery.
Mesh Attachment Time
Assessed at one time point, during the participants surgery.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perioperative Complications
Time Frame: Assessed at one time point, during the participants surgery.
Perioperative Complications
Assessed at one time point, during the participants surgery.
Postoperative Complications
Time Frame: Assessed at two time points, 6 weeks and 6 months postoperatively
Postoperative Complications
Assessed at two time points, 6 weeks and 6 months postoperatively
Surgeon Satisfaction
Time Frame: Assessed at one time point, during the participants surgery.
Surgeon Satisfaction assessed using a visual analog scale (10 point)assessment of satisfaction
Assessed at one time point, during the participants surgery.
Surgical Failure
Time Frame: Assessed at two time points, 6 weeks and 6 months postoperatively
Surgical Failure assessed using the pelvic organ prolapse quantification scoring system.
Assessed at two time points, 6 weeks and 6 months postoperatively
Vaginal wall appearance
Time Frame: Assessed at two time points, 6 weeks and 6 months postoperatively
Vaginal wall appearance assessed using a using a visual analog scale (10 point)assessment of overall appearance as well as sub-categories of anterior and posterior walls.
Assessed at two time points, 6 weeks and 6 months postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Study Director: Alexander A Berger, Kaiser Permanente
  • Principal Investigator: Shawn A Menefee, MD, Kaiser Permanente

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

November 29, 2017

Primary Completion (ANTICIPATED)

January 1, 2020

Study Completion (ANTICIPATED)

January 1, 2020

Study Registration Dates

First Submitted

December 4, 2017

First Submitted That Met QC Criteria

December 18, 2017

First Posted (ACTUAL)

December 20, 2017

Study Record Updates

Last Update Posted (ACTUAL)

March 6, 2019

Last Update Submitted That Met QC Criteria

March 4, 2019

Last Verified

March 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • 11460

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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