Image-Guided Herniorrhaphy Study

University of California (UC) Davis

Status: Not yet enrolling

Conditions: Hernia Abdominal Wall; Hiatal Hernia; Diastasis Recti; Hernia; Ventral Hernia; Inguinal Hernia

Treatments: Procedure: Image-Guided Herniorrhaphy

Study type: Interventional

Funder types: Other

Identifiers

NCT07267494

2345685

Details and patient eligibility

About

This pilot clinical study will evaluate the safety and effectiveness of a new image-guided, needle-based approach for repairing abdominal or groin hernias in adults who are unable or unwilling to undergo traditional open or laparoscopic surgery. The technique uses ultrasound and, when needed, CT imaging to guide a hollow needle preloaded with barbed suture through the skin to close the hernia defect without large incisions or general anesthesia. Each participant will undergo one image-guided procedure and will be followed for eight months to assess complications and changes in hernia-related quality of life. Approximately thirty participants will be enrolled. The study aims to determine whether this minimally invasive approach is safe, feasible, and capable of improving hernia symptoms enough to justify a larger clinical trial

Full description

Traditional hernia repair requires either open surgical incisions or laparoscopic entry into the abdomen, typically under general anesthesia. Although effective, these operations can be unsuitable for frail or medically complex patients because of anesthesia risks, postoperative pain, and wound complications.

This investigator-initiated pilot study explores a minimally invasive alternative: a percutaneous, image-guided herniorrhaphy that uses ultrasound or CT to visualize the hernia and guide placement of a barbed suture through a hollow needle to close the tissue defect. The goal is to assess procedural safety, feasibility, and short-term improvement in hernia-related quality of life.

Participants will be adults with reducible abdominal, groin, or hiatal hernias who are not candidates for standard surgery. The study procedure will be performed in the interventional radiology suite using local anesthesia with or without moderate sedation, following existing institutional workflows for other needle-based image-guided procedures.

Safety monitoring is provided by two independent physicians-a hernia surgeon and an interventional radiologist-who review study data quarterly and have authority to pause or stop the study if predefined complication criteria are met. Safety events will be categorized using the Society of Interventional Radiology adverse-event classification.

This study is intended to generate preliminary data on safety and patient-reported outcomes that can inform future trials of image-guided hernia repair techniques.

Enrollment: 30 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• English-speaking adult with reducible hernia(s) or diastasis smaller than approximately 8 cm seeking treatment for their hernia but not able or willing to undergo traditional surgery (open, laparoscopic, or robotic)
• Patient must be willing to undergo a novel 30- to 60-minute image-guided needle-based procedure

Exclusion criteria

• Children, prisoners, and pregnant women (possibly requiring a pregnancy test on the day of the procedure)
• Patients with a known reaction to local anesthetic or sedation medications or the suture material to be used
• Patients with irreducible hernias
• Patients with herniation not visible by ultrasound or CT
• Patients that do not fit the diameter of a CT gantry or the weight limit of the procedural CT table
• Patients without insurance or not willing to pay out-of-pocket for the study procedure

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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30 participants in 1 patient group

Image-Guided Herniorrhaphy

Experimental group

Description:

Single-arm pilot. All participants undergo a percutaneous, image-guided needle-based hernia repair performed under ultrasound and/or CT guidance with local anesthesia and optional moderate sedation. Follow-up includes clinic visits and quality-of-life assessments over \~8 months.

Treatment:

Procedure: Image-Guided Herniorrhaphy