Impact of Biosynthetic Mesh on Paraesophageal Hernia Repair
The Impact of Biosynthetic Mesh on Paraesophageal Hernia Repair in Robotic Anti-Reflux Surgery: A Multi-Institutional Randomized Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Annabel Endean, NP
- Phone Number: 646-962-5250
- Email: ant2028@med.cornell.edu
Study Contact Backup
- Name: Niloufar Salehi, MD
- Email: nis4017@med.cornell.edu
Study Locations
-
-
California
-
Los Angeles, California, United States, 90089
- Withdrawn
- University of Southern California Keck School of Medicine
-
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Louisiana
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New Orleans, Louisiana, United States, 70112
- Withdrawn
- Louisiana State University School of Medicine
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-
Missouri
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St Louis, Missouri, United States, 63110
- Withdrawn
- Washington University School of Medicine
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New York
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New York, New York, United States, 10065
- Recruiting
- Weill Cornell Medicine
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Contact:
- Niloufar Salehi, MD
- Phone Number: 212-746-5187
- Email: nis4017@med.cornell.edu
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Principal Investigator:
- Rasa Zarnegar, MD
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Contact:
- Annabel Endean, NP
- Phone Number: 646-962-5250
- Email: ant2028@med.cornell.edu
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New York, New York, United States, 10075
- Not yet recruiting
- Lenox Hill Hospital
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Contact:
- Mattia Ballo, MD
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Principal Investigator:
- Filippo Filicori, MD
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New York, New York, United States, 10016
- Not yet recruiting
- NYU Langone Health
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Principal Investigator:
- Tanuja Damani, MD
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Contact:
- Luis Espinosa, MD
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Documented diagnosis of gastroesophageal reflux disease
- Adults aged 18 years or older
- English speaking
- Subject is planned to undergo surgery for reflux disease
Exclusion Criteria:
- Physician deems the subject is unable to complete the study due to documented dementia.
- Subject is undergoing emergent surgery.
- Pregnancy
- Patient has known allergy to tetracycline hydrochloride or kanamycin sulfate
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: Biosynthetic Mesh
The biosynthetic mesh group will undergo hiatal hernia repair with Phasix Mesh (Becton Dickinson, Franklin Lakes, NJ) reinforcement, secured with permanent suture.
This is a biosynthetic mesh that completely reabsorbs in 12-18 months after surgery.
The mesh is designed to provide strength during the initial healing phase after hernia repair, allowing for rapid tissue ingrowth and vascularization, gradually transferring the load to native tissue as it resorbs1.
This mesh has been FDA approved for procedures involving soft tissue repair, such as hernia defects.
|
The biosynthetic mesh group will undergo hiatal hernia repair with Phasix Mesh (Becton Dickinson, Franklin Lakes, NJ) reinforcement, secured with permanent suture.
The non-mesh group will undergo hiatal hernia repair with permanent suture only.
|
|
Active Comparator: No Mesh
The non-mesh group will undergo repair with permanent suture only.
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The non-mesh group will undergo hiatal hernia repair with permanent suture only.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Anatomic hiatal hernia recurrence rate
Time Frame: 1 year
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Anatomic Hiatal Hernia Recurrence rate
Time Frame: 3 years
|
3 years
|
|
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Anatomic Hiatal Hernia Recurrence rate
Time Frame: 5 years
|
5 years
|
|
|
Reflux Symptoms
Time Frame: 2 weeks postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
2 weeks postoperatively
|
|
Reflux Symptoms
Time Frame: 6 months postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
6 months postoperatively
|
|
Reflux Symptoms
Time Frame: 1 year postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
1 year postoperatively
|
|
Reflux Symptoms
Time Frame: 2 years postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
2 years postoperatively
|
|
Reflux Symptoms
Time Frame: 3 years postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
3 years postoperatively
|
|
Reflux Symptoms
Time Frame: 4 years postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
4 years postoperatively
|
|
Reflux Symptoms
Time Frame: 5 years postoperatively
|
Reflux symptoms will be assessed using the gastroesophageal reflux disease health related quality of life survey (GERD-HRQL).
The highest possible score on this survey is 75, indicating daily incapacitating symptoms in all areas assessed.
The lowest possible score is 0, indicating no symptoms.
|
5 years postoperatively
|
|
Dysphagia Symptoms
Time Frame: 2 weeks postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
|
2 weeks postoperatively
|
|
Dysphagia Symptoms
Time Frame: 6 months postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
|
6 months postoperatively
|
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Dysphagia Symptoms
Time Frame: 1 year postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
|
1 year postoperatively
|
|
Dysphagia Symptoms
Time Frame: 2 years postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
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2 years postoperatively
|
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Dysphagia Symptoms
Time Frame: 3 years postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
|
3 years postoperatively
|
|
Dysphagia Symptoms
Time Frame: 4 years postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
|
4 years postoperatively
|
|
Dysphagia Symptoms
Time Frame: 5 years postoperatively
|
Dysphagia symptoms will be assessed using the Bazaz dysphagia score.
The lowest dysphagia severity score being "none", indicating no difficulty swallowing.
The highest dysphagia severity score being "severe", indicating frequent difficulty swallowing with the majority of foods.
|
5 years postoperatively
|
|
Number of subjects requiring 30 day readmission
Time Frame: 30 days following surgery
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30 days following surgery
|
|
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Number of subjects requiring reoperation
Time Frame: 30 days following surgery
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30 days following surgery
|
|
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Number of subjects developing postoperative Infection
Time Frame: 30 days following surgery
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30 days following surgery
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Rasa Zarnegar, MD, Weill Medical College of Cornell University
Publications and helpful links
General Publications
- Deeken CR, Matthews BD. Characterization of the Mechanical Strength, Resorption Properties, and Histologic Characteristics of a Fully Absorbable Material (Poly-4-hydroxybutyrate-PHASIX Mesh) in a Porcine Model of Hernia Repair. ISRN Surg. 2013 May 28;2013:238067. doi: 10.1155/2013/238067. Print 2013.
- Yamasaki T, Hemond C, Eisa M, Ganocy S, Fass R. The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger? J Neurogastroenterol Motil. 2018 Oct 1;24(4):559-569. doi: 10.5056/jnm18140.
- Li Q, Blume SW, Huang JC, Hammer M, Ganz ML. Prevalence and healthcare costs of obesity-related comorbidities: evidence from an electronic medical records system in the United States. J Med Econ. 2015;18(12):1020-8. doi: 10.3111/13696998.2015.1067623. Epub 2015 Sep 4.
- Spiro C, Quarmby N, Gananadha S. Mesh-related complications in paraoesophageal repair: a systematic review. Surg Endosc. 2020 Oct;34(10):4257-4280. doi: 10.1007/s00464-020-07723-0. Epub 2020 Jun 18.
- Alicuben ET, Worrell SG, DeMeester SR. Resorbable biosynthetic mesh for crural reinforcement during hiatal hernia repair. Am Surg. 2014 Oct;80(10):1030-3.
- Aiolfi A, Cavalli M, Sozzi A, Lombardo F, Lanzaro A, Panizzo V, Bonitta G, Mendogni P, Bruni PG, Campanelli G, Bona D. Medium-term safety and efficacy profile of paraesophageal hernia repair with Phasix-ST(R) mesh: a single-institution experience. Hernia. 2022 Feb;26(1):279-286. doi: 10.1007/s10029-021-02528-z. Epub 2021 Oct 30.
- Tartaglia E, Cuccurullo D, Guerriero L, Reggio S, Sagnelli C, Mugione P, Corcione F. The use of biosynthetic mesh in giant hiatal hernia repair: is there a rationale? A 3-year single-center experience. Hernia. 2021 Oct;25(5):1355-1361. doi: 10.1007/s10029-020-02273-9. Epub 2020 Jul 25.
- Panici Tonucci T, Asti E, Sironi A, Ferrari D, Bonavina L. Safety and Efficacy of Crura Augmentation with Phasix ST Mesh for Large Hiatal Hernia: 3-Year Single-Center Experience. J Laparoendosc Adv Surg Tech A. 2020 Apr;30(4):369-372. doi: 10.1089/lap.2019.0726. Epub 2020 Jan 7.
- Quake, S. Y. L., Peter, B., Munipalle, P. C., & Viswanath, Y. (2023). OGBN O08 The Safety and Efficacy of Laparoscopic Hiatus Hernia Repair with Biosynthetic Mesh (Phasix-ST®): A Single Centre Experience. British Journal of Surgery, 110(Supplement_8), znad348-030.
- Konstantinidis H, Charisis C. Surgical treatment of large and complicated hiatal hernias with the new resorbable mesh with hydrogel barrier (Phasix ST): a preliminary study. J Robot Surg. 2023 Feb;17(1):141-146. doi: 10.1007/s11701-022-01406-9. Epub 2022 Apr 9.
- Abdelmoaty WF, Dunst CM, Filicori F, Zihni AM, Davila-Bradley D, Reavis KM, Swanstrom LL, DeMeester SR. Combination of Surgical Technique and Bioresorbable Mesh Reinforcement of the Crural Repair Leads to Low Early Hernia Recurrence Rates with Laparoscopic Paraesophageal Hernia Repair. J Gastrointest Surg. 2020 Jul;24(7):1477-1481. doi: 10.1007/s11605-019-04358-y. Epub 2019 Aug 29.
- Oelschlager BK, Pellegrini CA, Hunter JG, Brunt ML, Soper NJ, Sheppard BC, Polissar NL, Neradilek MB, Mitsumori LM, Rohrmann CA, Swanstrom LL. Biologic prosthesis to prevent recurrence after laparoscopic paraesophageal hernia repair: long-term follow-up from a multicenter, prospective, randomized trial. J Am Coll Surg. 2011 Oct;213(4):461-8. doi: 10.1016/j.jamcollsurg.2011.05.017. Epub 2011 Jun 29.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 23-11026766
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
product manufactured in and exported from the U.S.
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