RecruitingNot ApplicableNCT07461558

Watchful Waiting Versus Immediate Repair for Occult Contralateral Inguinal Hernias.

WATCH IT TRIAL WAtchful Waiting Versus immediaTe Repair for Occult Contralateral Hernias Found During MIS Inguinal Hernia Repair Trial.


Sponsor

Northwestern University

Enrollment

380 participants

Start Date

Apr 1, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

This study will compare two ways of managing a small, hidden hernia that can sometimes be found during minimally invasive surgery to repair a hernia on one side of the groin. Occasionally while fixing the known hernia, the surgeon discovers a small hernia on the other side that has not caused any symptoms. Surgeons do not agree on the best way to handle these hernias. Some believe it should be repaired right away during the same operation to prevent it from getting bigger or from causing symptoms later, which could require another surgery. Others believe it is better to leave it alone since it is not causing problems and groin hernia surgery carries risks including long-term pain. This study will randomly assign patients, if a hidden hernia is found during surgery, to either having it repaired immediately or to have it monitored over time. Patients will be followed up at 30 days, 1 year and 2 years following surgery. The researchers will compare recovery and quality of life between the two groups. For those in the monitoring group, the study will also track whether the hidden hernia causes symptoms or eventually needs surgery. The goal is to determine whether repairing the hidden hernia right away is as safe and effective as watching and waiting, so doctors and patients can make more informed decisions in the future.


Eligibility

Min Age: 18 Years

Inclusion Criteria4

  • Male or female patients ≥18 years old
  • Symptomatic unilateral inguinal hernia
  • Occult contralateral hernia identified intraoperatively
  • Ability to provide informed consent

Exclusion Criteria6

  • Prior contralateral inguinal hernia repair
  • Symptomatic, bilateral inguinal hernias confirmed on physical exam
  • Contraindications to general anesthesia or surgery
  • Urgent or emergent presentations
  • Adults unable to consent
  • Pregnant patients

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Interventions

PROCEDUREsurgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines

Patients in the immediate occult hernia repair arm will under TAPP repair with placement of mesh of their occult inguinal hernia following repair of their symptomatic inguinal hernia.

PROCEDUREWatchful waiting with supportive care

Patients in the watchful waiting group will undergo standard TAPP inguinal hernia repair with mesh of their symptomatic hernia. Their occult hernia will be left alone. These patients will be followed postoperatively for occult hernia related emergencies including incarceration, strangulation or obstruction.


Locations(1)

Northwestern Memorial Hospital

Chicago, Illinois, United States

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NCT07461558


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