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| General |
| Study Status |
Ongoing |
Application Number /
Requirement Number |
P220024 / PAS001 |
| Date Original Protocol Accepted |
07/28/2023
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| Date Current Protocol Accepted |
01/14/2026
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| Study Name |
LiquiFix Post-Approval Study
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| Device Name |
LIQUIFIX FIX8 Hernia Mesh Fixation (HMF) Device, LIQUIFIX Precision Open Hernia Mesh Fixation Device
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| Clinical Trial Number(s) |
NCT04009213
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| General Study Protocol Parameters |
| Study Design |
Prospective Cohort Study
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| Data Source |
External Registry
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| Comparison Group |
Concurrent Control
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| Analysis Type |
Descriptive
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| Study Population |
Adult: At least 22 yrs
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| Detailed Study Protocol Parameters |
| Study Objectives |
A Post Approval Observational study using real-world data (RWD). The objective of the study is to evaluate the long-term safety of the LIQUIFIX implanted adhesive using real-world evidence methods through the ACHQC. Also see figure below (4.6)
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| Study Population |
Patients for this study will include all USA patients undergoing open or laparoscopic groin (inguinal/femoral) hernia repair, recruited from ACHQC participating institutions whose mesh fixation and peritoneal closure (in TAPP repair) is undertaken with the LIQUIFIX cyanoacrylate adhesive. As the data will be collected using real world evidence, sex, age, race will be most frequently observed in male, white, aged population and not further dictated by AMS. Inguinal hernias are the most common form of groin hernia and have a 9:1 male predominance, with a higher incidence among men over the age of 40 [1][2]. Additionally, white men have 2-times higher rate of incidence of inguinal hernia than black men [1]. Femoral hernias account for only 2% to 4% of all groin hernias and are more likely to occur in women than in men [3].
Any concomitant procedures will also be captured as part of the data collection.
A source comparator group will be used. This group will be concurrent propensity match scored and generated via ACHQC and will consist of patients where an alternative mesh fixation and peritoneal closure (for TAPP repair) was used. There will be a separate comparator group for each device specification (open and laparoscopic). Each comparator group has been selected based on current state of the art devices for each technique application:
For LIQUIFIX Fix8™ - Two groups of controls, Absorbable and Permanent Tackers will be used as the comparator
For LIQUIFIX Precision™ - Sutures, Staples and Tackers (absorbable and permanent) will be used as the comparator
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| Sample Size |
Number of subjects: n = 206 for LiquiFix Precision™ and n = 103 for LiquiFix Fix8™ or the number of patients at who are registered into the ACHQC at one year, whichever is the largest.
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| Key Study Endpoints |
Primary: The incidence of hernia recurrence in patients following groin hernia repair using LIQUIFIX will be measured using a concurrent propensity match control (via ACHQC) at 30 days and annually for a minimum of 2 years post-surgery.
Secondary 1: The incidence of reoperation in patients following groin hernia repair using LIQUIFIX will be measured using a concurrent propensity match control (via ACHQC) at 30 days and annually for a minimum of 2 years post-surgery.
Secondary 2: The incidence of surgical site infection in patients following groin hernia repair using LIQUIFIX will be measured using a concurrent propensity match control (via ACHQC) at 30 days and annually for a minimum of 2 years post-surgery.
Secondary 3: Levels of reported pain in patients following groin hernia repair using LIQUIFIX will be measured using a concurrent propensity match control (via ACHQC) at 30 days and annually for a minimum of 2 years post-surgery,
Secondary 4: Reported Quality of life in patients following groin hernia repair using LIQUIFIX will be measured using a concurrent propensity match control (via ACHQC) at 30 days and annually for a minimum of 2 years post-surgery
Secondary 5: The incidence of post operative complication rates following groin hernia repair using LIQUIFIX will be measured using a concurrent propensity match control (via ACHQC) at 30 days and annually for minimum 2 years post-surgery.
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| Follow-up Visits and Length of Follow-up |
Passive long-term follow up rates including email-based PRO engagement and routine clinical long-term follow up result in an estimated 20% completion at 2 years. Subjects follow up data collection intervals will occur at 30 days and annually for a minimum of 2 years post-surgery
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| Interim or Final Data Summary |
| Interim Results |
Safety Results:
LIQUIFIX FIX8™
30 day follow up:
• 81% (n=157) of patients were evaluated
• N=2 (1.3%) Gastrointestinal complications
o n=1 underwent a reoperation for bowel obstruction
o n=1 a readmission for a for a gastrointestinal bleed which was related to
nonsteroidal pain management use.
• N=1 (0.7%) Bleeding complication
• N=1 (0.6%) Hernia recurrence/ n=1 (0.6%) Re-operation for hernia recurrence
• N=2 (1.3%) (n=2) Surgical site infection.
• N=19 (12%) (n=19) Surgical site occurrences (1 wound cellulitis and 18 seroma)
1 year follow up:
• N=2 (1.3%) Re-operation for recurrence the patient is an 81 year old male, ASA 3, who had bilateral hernia repair for mesh fixation and peritoneal closure. Patient returned at 1 year with symptomatic hernia on left (L3L) that was confirmed by CT scan. This was treated with reoperation for recurrence.
• No Surgical site infections
No Surgical site occurrence
2 year follow up
• N=1 (1.1%) Surgical site infection
• N=1 (1.1%) Surgical site occurrence
• No reoperation for recurrence.
LIQUIFIX Precision™
30 day follow up:
• 70% (n=55) of patients were evaluated
• N=1 (1.8%) Readmission for wound complication
• No Recurrence recorded.
• N=1 (1.8%) Surgical site infection
• N=12 (22%) Surgical site occurrence (1 wound purulent drainage, 9 seroma, 1 infected seroma, 1 wound cellulitis and 2 haematoma). Patients may have multiple surgical site occurrences (patients could have more than one surgical site occurrence).
1 year follow up:
• N=1 (3.4%) Surgical site infections
• N= 1 (3.4%) Surgical site occurrence (mesh excision)
• N= 1 (2.2%) re-operation for port site hernia recurrence which was unrelated to LIQUIFIX Precision™
2 year follow up
• No reoperation for recurrence
• No surgical site infections
• No surgical site occurrences
Effectiveness Results:
LIQUIFIX FIX8™
• 30 day: 1.3% (n=2) gastrointestinal complications, one underwent a reoperation for bowel obstruction, one for a GI bleed which was related to nonsteroidal \ pain management, 0.7% (n=1) for post-operative bleeding and 0.6% (n=1) underwent a reoperation for recurrence
• 1 year: 1.3% (n=2) reoperation for recurrence. One patient, an 81 year old male, ASA 3, who had bilateral hernia repair for mesh fixation and peritoneal closure. Patient returned at 1 year with symptomatic hernia on left (L3L) that was confirmed by CT scan. This was treated with reoperation for recurrence.
• had a very complex course-multiple recurrent inguinal hernia repair, came back with an infection that required IR drainage and suppressive antibiotics.
• 2 year: no reoperation for recurrence
LIQUIFIX Precision™
• 30 day: n=1 (4%) readmission for a wound complication
• 1 year: 2.2% (n=1) reoperation for port site hernia recurrence, which was unrelated to LIQUIFIX Precision™, 3.4% (n=1) Surgical Site Occurrence, this was a case in which the mesh was excised.
• 2 year: No reoperation for recurrence
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| Actual Number of Patients Enrolled |
273 patients are enrolled (194 for FIX8 and 79 for Precision)
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| Actual Number of Sites Enrolled |
This study is based on data already collected in the ACHQC.
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| Patient Follow-up Rate |
For FIX8, the 30 day, 1 year, and 2 year follow up rates are at 81%, 72.7%, and 54.6%, respectively. For Precision, the 30 day, 1 year, and 2 year follow up rates are at 69.6%, 40.5%, and 7.6%, respectively. (NOTE that the percentages for 1 and 2 year follow up pertain to recurrence follow up).
Due to the nature of this observational post-approval study and use of registry data, the Sponsor is unable to get patient lost-to-follow-up information at this interim timepoint as aggregate information is provided.
In accordance with the Protocol, missing data will be minimized in the following manner:
Data collection for each time point will continue until the desired number of patients required to fulfill this study are entered into the ACHQC, i.e., numbers enrolled at 1 year post approval or n=206 for LIQUIFIX Precision™ and n= 103 LIQUIFIX FIX8™ whichever is the largest, as well as continued follow-up of the available IDE patients (approximately 103).
Also, any patients who do not provide follow-up data at any time points defined in this protocol may be entered into the ACHQC patient outreach program. This program is a proactive method of follow-up provided by ACHQC and consists of qualified clinicians who will contact patients and/or undertake a historical and retrospective chart review.
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