Inguinal Hernia

Researchers are evaluating the use of local versus general anesthesia for inguinal hernia repair in Veterans aged 60 years and older. This pilot study aims to gather data to plan a larger, multisite randomized clinical trial by testing study procedures, recruiting participants, and measuring relevant outcomes. The study also seeks to identify barriers to wider use of local anesthesia and to provide training in clinical trial design and conduct. Participants are randomly assigned to one of three groups: open inguinal hernia repair with local anesthesia, open inguinal hernia repair with general anesthesia, or laparoscopic/robotic hernia repair with general anesthesia. Local anesthesia involves injecting a mix of lidocaine with epinephrine and Marcaine at the surgical site along with intravenous sedation and pain medication. General anesthesia uses inhaled and intravenous anesthesia. The laparoscopic or robotic approach is included as it cannot be performed using local anesthesia. During the 6-month study period, participants will undergo surgery and anesthesia as assigned, followed by evaluations at various time points including baseline, 48 hours, 2 weeks, and 6 months after surgery. Researchers will collect data on enrollment rates, participant retention, time to complete assessments, satisfaction, pain levels, cognitive function, delirium, postoperative complications, and recovery times. This information will help refine study instruments and inform the design of future larger trials.

Researchers are evaluating the safety and effectiveness of the Symani Surgical System in microsurgical anastomosis during free tissue transfer surgery and lymphovenous anastomosis surgery. This observational study aims to assess the device's performance in real-world settings, focusing on the rate of successful vessel connection in the first surgical attempt and the absence of device-related adverse events. Participants will receive standard surgical care using the Symani Surgical System, which offers articulated, interchangeable instruments designed for open microsurgery procedures. The study includes patients undergoing free tissue transfer of the breast or extremities and those having lymphovenous anastomosis surgery for lymphedema. During the trial, participants will have their surgical procedures assessed and may complete questionnaires if undergoing lymphedema procedures. Throughout the study, researchers will monitor the safety and effectiveness of the device by evaluating intraoperative vessel patency and tracking any adverse events up to 30 days after surgery. Participants will be asked to allow access to their medical information, attend follow-up visits, and complete all study procedures and questionnaires. The total participation covers the surgery period and a 30-day post-surgery follow-up to ensure comprehensive safety and outcome monitoring.

This observational study aims to understand how force feedback instruments are useful during surgeries performed with the da Vinci 5 robotic system. It focuses on procedures such as inguinal and ventral hernia repairs, colorectal, thoracic, gynecologic surgeries, and partial nephrectomy. The study is designed to gather information on how these instruments perform during robotic-assisted surgery. Participants will undergo multi-port robotic-assisted surgery using the da Vinci 5 system equipped with force feedback instruments, which provide tactile sensations. The study observes surgeries planned as primary procedures with these instruments, without altering the treatment. There is no experimental drug or placebo involved, as this is an observational study conducted after the devices have been marketed. During the study, researchers will measure the force applied to tissues by the force feedback instruments during surgery and evaluate how useful these instruments are during specific steps of the procedure before patient discharge. Participants will be followed up as per the study protocol to ensure data quality. The total participation time varies depending on the surgical procedure and follow-up schedule.

Researchers are investigating the effects of different physical activity guidelines following surgery for single-sided inguinal hernia repair. This pilot study compares outcomes between patients given standard lifting restrictions and those allowed to return to activity based on their comfort. The goal is to see if allowing patient autonomy can reduce recovery time while monitoring complications, hernia recurrence, physical activity levels, and quality of life. Participants will be randomly assigned to one of two groups after surgery: a control group following standard precautions (lifting no more than 20 pounds for 6 weeks after open surgery or 2 weeks after minimally invasive surgery), or a treatment group advised to resume activities as tolerated but to stop if pain occurs. Surgery will be performed according to usual medical care. Data will be collected through pre- and post-operative questionnaires, clinical visits, and medical chart reviews. Throughout the study, participants will be assessed on their surgical recovery, timing of return to physical activity, and overall quality of life. Researchers will monitor hernia recurrence and post-surgery complications for up to two years. Questionnaires about activity levels will be completed within six weeks after surgery. All data will be securely stored and analyzed to compare outcomes between the two groups.

This research aims to evaluate the safety and performance of the ECLIPSIUM device in securing mesh during ventral hernia repair. It compares ECLIPSIUM, a bioresorbable polymer-based fixation device, to bioresorbable tacks to determine if it can reduce the risk of hernia recurrence. The study is a prospective, multi-center, randomized, single-blind trial designed to assess whether ECLIPSIUM offers clinical benefits in laparoscopic intraperitoneal onlay mesh ventral hernia repair procedures. Participants will receive one of two treatments: the ECLIPSIUM System, which applies a biodegradable polymer coating to the mesh and secures it with photoactivation using a special curing light, or resorbable tacks that fasten the mesh and are absorbed by the body over time. Each participant undergoes laparoscopic ventral hernia repair with mesh fixation using either method. The study will monitor outcomes over 12 months, including hernia recurrence and complications. During the study, participants will have assessments at 6 and 12 months to check for hernia recurrence and any complications. The trial includes follow-up visits and evaluations to monitor safety and effectiveness. Participants will be observed for the cumulative incidence of complications up to 12 months, and the primary outcome measurement is hernia recurrence at 6 months. The total duration of participation will vary depending on individual follow-up schedules.

Researchers are investigating the effects of a categorized physical therapy program on people with non-arthritic hip and groin pain. This study addresses a gap in current research, which has mostly focused on osteoarthritis of the hip, by exploring how a standardized physical therapy approach can help those without arthritis-related hip problems. The trial is randomized and aims to better understand treatment options for hip and groin pain. Participants will be assigned to one of two groups: one receiving standard-of-care physical therapy, and the other receiving matrix-based physical therapy in addition to the standard care. Matrix-based therapy involves tailoring stretches and strengthening exercises based on the patient's hip mobility and strength. Both approaches will be monitored over the course of the study. Throughout the study, participants will be evaluated using the International Hip Outcome Tool-12 (iHOT-12) for up to 6 months to measure hip function and health. Pain levels will be assessed with a numerical rating scale, and adherence to home exercise programs will be tracked. The study includes double-masked procedures to reduce bias and will provide detailed monitoring of participants' progress and response to therapy.

Pelvic pain is a common but often under-reported condition in healthy adults, occurring more frequently in women than in men. Many individuals with pelvic pain may underestimate its severity, yet chronic pelvic pain can be managed successfully if diagnosed promptly. This observational study analyzes prospective clinical data to evaluate the prevalence and management of pelvic pain in adults, focusing on treatment outcomes and complications. The study includes adult patients experiencing chronic pelvic, inguinal, sacroiliac, coccygeal, or piriformis pain. It examines the use of various multimodal analgesia methods alongside rehabilitation therapy as behavioral interventions. The research observes the types of rehabilitation therapy used and their effects on pain management without assigning specific treatment groups. The study follows patients over time to analyze outcomes. Participants will be assessed using the Numeric Pain Rating scale over a 12-month period to objectively measure pain levels. Researchers will collect clinical data on treatment types, rehabilitation therapies, and any complications. As an observational study, participants' usual care continues while data is gathered to understand pain management better. The total participation time varies depending on individual treatment and follow-up schedules.

Researchers are studying pain management techniques for patients undergoing inguinal hernia repair, a common surgical procedure. Despite being classified as minor surgery, many patients experience moderate to severe pain after the operation, with some developing chronic pain that impacts their quality of life. This study aims to compare two ultrasound-guided nerve block techniques, the Quadro-iliac Plane Block (QIPB) and the transversus abdominis plane block (TAPB), to see which provides better pain relief. Participants will be randomly assigned to receive either the TAPB or QIPB procedure under ultrasound guidance during their hernia surgery. Both procedures involve injecting 30 ml of 0.25% bupivacaine to block pain signals, with TAPB performed while lying on the back and QIPB while lying on the side. These blocks are intended to be part of multimodal pain control during and after surgery. During the study, researchers will monitor pain scores for up to 24 hours after surgery and assess patient satisfaction at the 24-hour mark. Patients will be observed in a controlled setting during and after the procedure to evaluate the effectiveness of each nerve block. The study includes adults aged 18 to 65 undergoing unilateral inguinal hernia repair under general anesthesia, and participation lasts through the immediate postoperative period.

Inguinal hernia is a common condition with a high lifetime risk, especially in men. Researchers are studying the early recovery after laparoscopic inguinal hernia repair using either a conventional laparoscopic method (l-TAPP) or a robot-assisted laparoscopic method (r-TAPP). The study focuses on patients with bilateral groin hernias and aims to compare outcomes such as recovery and quality of life after surgery. Participants will be randomly assigned to one of four groups: conventional laparoscopic repair with or without local anesthetics, and robot-assisted laparoscopic repair with or without local anesthetics. The study uses a self-fixating mesh placed via a laparoscopic transabdominal pre-peritoneal approach. The robot-assisted technique has been used since 2016, and this trial will further assess its early postoperative effects compared to the conventional method. Participants will complete quality of life questionnaires before surgery, and at one month and twelve months after surgery. The main outcome measured is the change in the Post Anesthetic Discharge Scoring System (PADSS) score within 24 hours after surgery or until a score of 9 or higher is reached. Researchers will also monitor recurrence rates at 12 months and assess quality of life during follow-up visits. The total study duration is expected to last until December 2029.

Researchers are evaluating the effects and safety of dexamethasone palmitate compared to traditional dexamethasone for preventing postoperative nausea and vomiting (PONV) after open surgery. Although dexamethasone is commonly used to reduce PONV, some patients still experience symptoms within 24 hours after surgery. Dexamethasone palmitate has a longer-lasting anti-inflammatory effect and fewer side effects, making it a promising option for managing PONV. Participants will be randomly assigned to one of two groups. One group will receive an intravenous injection of dexamethasone palmitate 8 mg (containing 5 mg dexamethasone) after anesthesia induction and before surgical incision. The other group will receive an intravenous injection of dexamethasone 5 mg at the same time. The trial compares these treatments in patients undergoing elective open surgeries such as spinal, chest, or abdominal surgery. During the study, researchers will monitor participants for the incidence and severity of PONV at multiple time points within 72 hours after surgery. They will also track the use of rescue antiemetic medications, participant satisfaction with PONV management, pain levels using the VAS scale, quality of postoperative recovery, length of hospital stay, and safety outcomes up to one month after surgery. The main outcome is the occurrence of PONV within the first 24 hours postoperatively. Participation lasts through the surgery and follow-up periods as described.