Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP)
Short-term Outcome and Inflammatory Stress Response Following Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP) - A Prospective, Randomized Trial Comparing Laparoscopy to the Robotic-assisted Approach
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Alexandros Nikolaou Valsamidis
- Phone Number: 0045 79973539
- Email: alexandros.nikolaou.valsamidis@rsyd.dk
Study Contact Backup
- Name: Michael Festersen Nielsen
- Phone Number: 0045 79976275
- Email: michael.festersen.nielsen@rsyd.dk
Study Locations
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-
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Aabenraa, Denmark, 6200
- Sygehus Soenderjylland
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- ASA 1- 3
- Clinical or radiologic diagnosis of inguinal hernia (unilateral, bilateral, recurrent, inguinoscrotal)
- Eligible for a laparoscopic procedure
- Informed concent
Exclusion Criteria:
- Incarcerated inguinal hernia requiring emergency surgery
- Pregnancy
- Patients with chronic pain due to arthritis, migraine or other illness requiring regular intake of pain relieve (paracetamol, NSAID etc)
- Active cancer
- History of psychiatric or additive disorder that prevent the patient from participating in the trial
- Co-existing inflammatory disease
- Co-existing immunological disease that requires medication of any kind
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Robotic TAPP
Repair of primary unilateral and bilateral hernias with robotic technology
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Robotic TAPP consists of four different procedures.
Part 2 and 3 will be the same for both procedures and will consist of hernia reduction and preparation of the preperitoneal space where the mesh is placed (part 2), mesh placement and suturing of the peritoneum (part 3).
Part 1 consists of docking of the robot and port placement and part 4 consists of de-docking and skin closure
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Active Comparator: Laparoscopic TAPP
Repair of primary unilateral and bilateral hernias with laparoscopic repair
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Laparoscopic TAPP consists of four different procedures.
Part 2 and 3 will be the same for both procedures and will consist of hernia reduction and preparation of the preperitoneal space where the mesh is placed (part 2), mesh placement and suturing of the peritoneum (part 3).
Part 1 consists of port placement only and part 4 consists of skin closure only.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Surgical stress response (CRP)
Time Frame: CRP will be measured preoperatively at baseline, 1 day postoperatively and 3 days postoperatively
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Change of serum CRP over time.
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CRP will be measured preoperatively at baseline, 1 day postoperatively and 3 days postoperatively
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Estimated intraoperative blood loss
Time Frame: intraoperative (From first incision until last suture has been placed)
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The amount of intraoperative blood loss measured in mL, estimated by the primary surgeon
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intraoperative (From first incision until last suture has been placed)
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|
Intraoperative need of blood transfusion
Time Frame: intraoperative (From first incision until last suture has been placed)
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The amount of blood transfused during surgery measured in mL
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intraoperative (From first incision until last suture has been placed)
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Length of hospital stay
Time Frame: Up to 3 months
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The number of days patients spend in the hospital following the procedure.
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Up to 3 months
|
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Hernia defect size
Time Frame: During surgery
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The area of the hernial defect in cm2 measured at 8 mmHg
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During surgery
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Total surgical time
Time Frame: During surgery
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The procedure will be divided into 4 parts.
Part 1 will be different for the 2 procedures.
In rTAPP it will consist of docking of the robot and port placement while it only will consist of port placement in TAPP.
Part 2 and 3 will be the same for both procedures and will consist of hernia reduction and preparation of the preperitoneal space where the mesh is placed (part 2), mesh placement and suturing of the peritoneum (part 3).
Part 4 will also be different for the 2 procedures.
In rTAPP it will consist of de-docking and skin closure while it only will consist of skin closure in TAPP.
Total surgical time and each part will be measured individually in minutes and the 2 procedures will be compared
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During surgery
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Postoperative complications
Time Frame: From surgery until 6 months postoperatively
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Classified into grades (I-V) according to the Clavien-Dindo classification
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From surgery until 6 months postoperatively
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Life-quality
Time Frame: From inclusion until 6 months postoperatively
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According to the EUropean Registry for Abdominal wall HerniaS Quality Of Life questionnaire (Eura-HS QoL).
The total score ranges from 0 (best quality of life) to 90 (worst quality of life)
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From inclusion until 6 months postoperatively
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Sexual dysfunction
Time Frame: From inclusion until 6 months postoperatively
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According to the Sexual Inguinal Hernia Questionnaire (SexIHQ) a 1-page, 8-question questionnaire including visual analogue scales and tick-boxes used to asses sexual dysfunction following inguinal hernia repair
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From inclusion until 6 months postoperatively
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Surgical stress response (IL1-β)
Time Frame: IL1-β will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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The change of serum IL1-β over time.
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IL1-β will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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Surgical stress response (IL-6)
Time Frame: IL-6 will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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The change of serum IL-6 over time.
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IL-6 will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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Surgical stress response (IL-8)
Time Frame: IL-8 will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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The change of serum IL-8 over time.
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IL-8 will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
|
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Surgical stress response (IL-10)
Time Frame: IL-10 will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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The change of serum IL-10 over time.
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IL-10 will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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Surgical stress response (TNF-α)
Time Frame: TNF-α will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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The change of serum TNF-α over time.
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TNF-α will be measured preoperatively at baseline, 30 minutes after extubation and 120 minutes after extubation
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;2003(1):CD001785. doi: 10.1002/14651858.CD001785.
- Podolsky D, Novitsky Y. Robotic Inguinal Hernia Repair. Surg Clin North Am. 2020 Apr;100(2):409-415. doi: 10.1016/j.suc.2019.12.010. Epub 2020 Feb 1.
- Huerta S, Timmerman C, Argo M, Favela J, Pham T, Kukreja S, Yan J, Zhu H. Open, Laparoscopic, and Robotic Inguinal Hernia Repair: Outcomes and Predictors of Complications. J Surg Res. 2019 Sep;241:119-127. doi: 10.1016/j.jss.2019.03.046. Epub 2019 Apr 22.
- Valorenzos A, Nielsen KA, Kaiser K, Petersen SR, Helligso P, Dorfelt A, Lambertsen KL, Ellebaek MB, Nielsen MF. Inflammatory response and short-term outcomes after laparoscopic versus robotic transabdominal preperitoneal inguinal hernia repair: randomized clinical trial (ROLAIS). Br J Surg. 2025 Mar 28;112(4):znaf074. doi: 10.1093/bjs/znaf074.
- Valorenzos AV, Nielsen KA, Kaiser K, Helligso P, Ellebaek MB, Dorfelt A, Petersen SR, Pedersen AK, Nielsen MF. Short-term outcomes and inflammatory stress response following laparoscopy or robotic-assisted transabdominal preperitoneal inguinal hernia repair (TAPP): study protocol for a prospective, randomized trial (ROLAIS). Trials. 2024 Aug 8;25(1):529. doi: 10.1186/s13063-024-08361-w.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SHS-MT Kir - 1 - 2023
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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