Watchful Waiting vs. Repair of Oligosymptomatic Incisional Hernias (AWARE)

• Applicant: Privatdozent Dr. Johannes C. Lauscher, since 10/2017
• Subject Area: General and Visceral Surgery
• Term: from 2011 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 174141364

Incisional hernias are one of the most frequent complications in abdominal surgery. In Germany, 44.000 incisional hernia repairs per year are performed. Incisional hernia repair is not a low risk operation associated with high recurrence rate and high percentage of postoperative pain. Treatment of incisional hernias represents a significant surgical and socioeconomic problem. Until now, surgical treatment is recommended for patients with incisional hernia independent of symptoms due to the risk of an acute incarceration with serious complications. Studies defining the exact indications for incisional hernia repair and describing the natural course of an incisional hernia including the risk of an acute incarceration are not available to date. Randomized controlled trials having been performed in the past few years show that observation is a reasonable option in mildly symptomatic inguinal hernias. In this study, watchful waiting vs. open surgical repair of oligosymptomatic incisional hernias are compared in a prospective-randomized setting for the first time. The aim is to determine pain and discomfort, quality of life, patient satisfaction, and the frequency of incarceration. We hypothesize that pain intensity during everyday activities is not different in the compared groups and that incarceration frequency is low. If this was the case, a watchful waiting strategy could be applied in oligosymptomatic incisional hernias and risks and costs for surgery could be saved.

• DFG Programme: Clinical Trials
• Participating Persons: Professor Dr. Heinz J. Buhr; Privatdozent Dr. Jörg-Peter Ritz
• Ehemaliger Antragsteller: Professor Dr. Martin Kreis, from 1/2016 until 10/2017