Clinical Research Directory

Comparison of Two Surgical Techniques for Indirect Inguinal Hernia Repair

This study will compare two ways of managing the hernia sac during laparoscopic surgery for an indirect inguinal hernia, a type of groin hernia. A hernia sac is a pouch of tissue that extends through the hernia opening. In the standard technique, the sac is fully separated from nearby structures and returned to the abdomen. In the alternative technique, called Primary Abandon of the Sac (PAS), the lower part of the sac is left in place to reduce the amount of tissue dissection. Both techniques use mesh to repair the hernia. The main question is whether leaving the lower part of the sac in place results in an acceptably similar rate of seroma compared with the standard technique. A seroma is a collection of fluid near the area where surgery was performed. The study will also compare operation time, pain, quality of life, complications, return to daily activities, and whether the hernia comes back. The study plans to enroll 90 adults with a primary indirect inguinal hernia on one side who are scheduled for elective laparoscopic repair. Participants will be assigned by chance to one of the two surgical techniques, with an equal chance of receiving either technique. Participants and the researchers assessing their recovery will not know which technique was used; the operating surgeon will know. Participants will have follow-up assessments at 1 day, 7 days, 1 month, 6 months, and 12 months after surgery. The main assessment of seroma will take place 30 days after surgery.

INVESTIGATION OF THE GENETIC ETIOLOGY OF HERNIA SAC DEVELOPMENT IN MALE CHILDREN WITH UNDESCENDED TESTIS AND INGUINAL HERNIA

The aim of the project is to elucidate the genetic etiology underlying the development of the processus vaginalis (PV) in male children with indirect inguinal hernia (IIH) and undescended testis (UT), through the investigation of potential variants in the INSL3, WT1, and GATA6 genes using next-generation sequencing (NGS), and to explore possible differences in the tissue-level expression of these genes by real-time PCR analysis. Indirect inguinal hernia represents a significant clinical problem for human health, due to its high prevalence in the population and its potential to cause life-threatening conditions or permanent functional loss. The treatment of both of these conditions, under current circumstances, requires surgical intervention. In the course of IIH, segmental loss of reproductive organs and intestines in both girls and boys, together with ischemia-reperfusion injury occurring in these tissues, constitute serious medical complications that cannot be overlooked. Furthermore, the substantial economic cost associated with the management of such severe complications necessitates meticulous control of the process. UT, on the other hand, is being observed with increasing frequency today and represents a significant health problem in society, as it is closely associated with reproductive disorders. Clarifying the mechanisms underlying the pathogenesis of both inguinal region diseases will make a critical contribution not only to protecting individual health, but also to advancing societal well-being and scientific knowledge. Moreover, the data obtained from this study are expected to provide new perspectives for IIH and UT treatment approaches and form a scientific basis for future studies in the field. This prospective cross-sectional study will comprise 20 patients with indirect inguinal hernia, 20 patients with undescended testis, and 20 patients undergoing circumcision, consecutively admitted to the Department of Pediatric Surgery, Faculty of Medicine, Trakya University. Patent processus vaginalis tissues excised during surgery from patients with IIH and UT, and preputial tissues obtained from patients in the circumcision group, will be collected. Tissue and blood samples taken from the patients will be transferred to the Department of Medical Genetics, Faculty of Medicine, Trakya University, for further analyses.