Suprapubic Transverse Incision With Rectus Release for Upper Peritoneal Access): A Novel Dual-Plane Technique for Abdominal Wall Incision in Complex Gynecological Surgery

NCT07373886 | Not Yet Recruiting

• 1 other identifier: MS-599-2025
• Study Type: interventional
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to evaluate the clinical effectiveness, anatomical benefits, and postoperative outcomes of the STIRRUP incision (Suprapubic Transverse Incision with Rectus Release for Upper Peritoneal Access) by comparing outcomes with historically established benchmarks and published data from traditional abdominal wall incisions used in complex gynecologic surgery.

Conditions

Post-Op Complication

Outcome Measures

Primary Outcomes (1)

• Postoperative seroma formation

  clinically detectable subcutaneous fluid collection at the incision site, confirmed clinically and/or by ultrasound when indicated.

  within the postoperative or follow-up period (6 months)

Study Arms (1)

STIRRUP (Suprapubic Transverse Incision with Rectus Release for Upper Peritoneal access) technique

EXPERIMENTAL

Skin incision: A low curvilinear transverse incision will be made 2-3 cm above the pubic symphysis, corresponding to the Pfannenstiel site. Subcutaneous dissection: The subcutaneous tissue will be elevated between Scarpa's fascia and the anterior rectus sheath for approximately 10-12 cm cephalad. Anterior rectus sheath incision: A transverse incision will be made in the anterior rectus sheath approximately 10-12 cm above the pubis, parallel to the skin incision. The linea alba will not be divided, thereby preserving midline fascial integrity. Rectus muscle separation: Beneath the fascial window, the rectus muscles will be separated bluntly at the midline, as in the Pfannenstiel approach, to expose the posterior sheath and peritoneum. No transection of muscle fibers will be performed. Peritoneal entry: The peritoneum will be opened sharply under direct vision.

Procedure: STIRRUP (Suprapubic Transverse Incision with Rectus Release for Upper Peritoneal access) technique

Interventions

STIRRUP (Suprapubic Transverse Incision with Rectus Release for Upper Peritoneal access) technique PROCEDURE

Skin incision: A low curvilinear transverse incision will be made 2-3 cm above the pubic symphysis, corresponding to the Pfannenstiel site. Subcutaneous dissection: The subcutaneous tissue will be elevated between Scarpa's fascia and the anterior rectus sheath for approximately 10-12 cm cephalad. Anterior rectus sheath incision: A transverse incision will be made in the anterior rectus sheath approximately 10-12 cm above the pubis, parallel to the skin incision. The linea alba will not be divided, thereby preserving midline fascial integrity. Rectus muscle separation: Beneath the fascial window, the rectus muscles will be separated bluntly at the midline, as in the Pfannenstiel approach, to expose the posterior sheath and peritoneum. No transection of muscle fibers will be performed. Peritoneal entry: The peritoneum will be opened sharply under direct vision.

STIRRUP (Suprapubic Transverse Incision with Rectus Release for Upper Peritoneal access) technique

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Female patients aged 18-65 years
• Indication for open gynecologic surgery for benign or borderline pelvic or abdominopelvic masses
• Body Mass Index (BMI) ≥ 18 kg/m²
• Willing and able to provide informed consent and attend follow-up
• Mass size between 15-30 cm, which is considered optimal for the STIRRUP (Suprapubic Transverse Incision with Rectus Release for Upper Peritoneal access) technique due to the balance between exposure and minimal morbidity

You may not qualify if:

• Malignant tumors requiring upper abdominal visceral resection (liver, spleen, diaphragm)
• Emergency surgery
• Previous complex abdominal wall reconstruction with mesh
• Contraindication to general anesthesia
• Masses extending to the xiphisternum or measuring \>30 cm
• Cases requiring supracolic omentectomy
• Planned lymphadenectomy (especially if comprehensive para-aortic lymph node dissection is required )
• Supramesocolic tumor extension or malignant ovarian tumors requiring hepatic resections, splenectomy, and diaphragmatic resection
• Severe comorbidities precluding elective surgery
• Pregnancy
• Previous extensive upper abdominal surgery

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Postoperative Complications

Interventions

Methods

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Investigative Techniques

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of Obstetrics and Gynecology

Study Record Dates

• First Submitted: January 21, 2026
• First Posted: January 28, 2026
• Study Start: February 1, 2026
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: January 28, 2026

Record last verified: 2026-01