The Transrectus Sheath Pre-peritoneal (TREPP) Technique for Strangulated Inguinal Hernia: a Case-series

NCT03935490 | Completed

• 1 other identifier: 201900143
• Study Type: observational
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

n the Sint Jansdal Hospital in Harderwijk, the Netherlands, the TREPP technique is the standard operating procedure for patients with inguinal hernia. Starting from 2006, this procedure has also been used on patients that presented with an acute strangulated inguinal hernia in the emergency department, instead of the more common Lichtenstein technique. The goal of this retrospective case series is to assess the feasibility of the TREPP technique in case of an acute strangulated inguinal hernia. Patient records from 2006 until 2016 will be used to search for patients treated for acute inguinal hernia in that period. After applying the in- and exclusion criteria, patients who are eligible for inclusion will be contacted by telephone. They will be asked if they are willing to visit the surgical outpatient department once and fill out two questionnaires. The data of these questionnaires will be analyzed and published.

Conditions

Strangulated Inguinal Hernia

Keywords

Inguinal hernia; Strangulated; TREPP; Transrectus sheath pre-peritoneal

Outcome Measures

Primary Outcomes (2)

• Chronic postoperative inguinal pain according to Visual Analog Scale

  Patients will be asked to fill out the VAS on a horizontal line of 10 millimeters long. Patients will be asked to mark the point that indicated the amount of pain they experience. The distance from the left marker will be measured, with increasing distance at greater pain intensity.

  From surgery date up to 12 years postoperatively

• Recurrence rate

  Patient electronic records will be searched for re-operations for recurrent inguinal hernia. Also, patients will be asked in the outpatient department if they received recurrence surgery or suffer new complaints.

  From surgery date up to 12 years postoperatively

Secondary Outcomes (2)

• Short-term complications

  Complications occuring from the start of the operation up to 30 days postoperative

• Sexual complaints related to e-TREPP

  Between >30 days postoperatively and through study completion, average 6 years

Study Arms (1)

e-TREPP

Patients with strangulated inguinal hernia treated with e-TREPP

Procedure: emergency transrectus sheath pre-peritoneal mesh repair (e-TREPP)

Interventions

emergency transrectus sheath pre-peritoneal mesh repair (e-TREPP) PROCEDURE

The Trans REctussheath PrePeritoneal mesh repair (TREPP) was developed in 2006 as an open preperitoneal technique to reduce CPIP. In short: a 4-5 centimeters (cm) transverse incision is made about 1 cm above the localization of the deep inguinal ring. The anterior rectus sheath is opened. After retracting the rectus muscle medially, the preperitoneal space (PPS) is bluntly dissected and a complete overview can be achieved. All possible hernia orifices can be visualized such as: a direct, indirect, pantaloon, and/or femoral hernia. A self-expandable mesh is then positioned in the PPS. Due to the "upstream principle" no mesh fixation is necessary.

e-TREPP

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

From all acute inguinal hernia repairs patient records will searched for e-TREPP procedures. All patients will be asked to visit the outpatient department.

You may qualify if:

• Emergency surgery for suspected strangulated inguinal hernia (within 6 hours after admission)
• e-TREPP performed

You may not qualify if:

• No emergency surgery (for instance, surgery day after admission or later).
• No e-TREPP performed

Sponsors & Collaborators

• University Medical Center Groningen: lead
• St Jansdal Hospital: collaborator

Study Sites (1)

St Jansdal Hospital

Harderwijk, Gelderland, 3844 DG, Netherlands

Location

MeSH Terms

Conditions

Hernia, Inguinal

Condition Hierarchy (Ancestors)

Hernia, Abdominal; Hernia; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 29, 2019
• First Posted: May 2, 2019
• Study Start: May 1, 2019
• Primary Completion: July 1, 2019
• Study Completion: July 12, 2019
• Last Updated: March 26, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

NL (1)