Closing the hiatus with omentopexy and left-crus fixation during robotic oesophagectomy to prevent para-conduit hernia
Official title: The PHARO Trial: The Incidence of Para-conduit Hernia With Closure of Hiatus Versus the Standard Approach in Robotic Oesophagectomy - A Randomised Controlled Pilot Trial
Run by Royal College of Surgeons, Ireland · NCT07426835 · Data updated 2026-11-12
This study will test whether routinely closing the hiatus with omentopexy and fixing the left crus during robotic oesophagectomy reduces para-conduit hernia in adults having surgery for non-metastatic oesophageal cancer.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 40 (estimated) |
| Sponsor | Royal College of Surgeons, Ireland Academic / other |
| Locations | 1 site (Dublin, Beaumont) |
| Status | Recruiting |
| Started | December 19, 2025 |
| Main results expected | December 31, 2027 |
| Study ends | December 31, 2029 |
| Registry record updated | February 23, 2026 |
| Trial ID | NCT07426835 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18 years) with non-metastatic oesophageal cancer planned for curative-intent robotic oesophagectomy who can provide informed consent are the intended participants.
✕Probably not a fit
Patients with distant metastatic disease, those not suitable for robotic oesophagectomy, or those unable to give informed consent would not be eligible and are unlikely to benefit from this intervention.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
The PHARO trial is a single-centre, single-blinded, randomised pilot comparing standard hiatal management (no or partial closure) with hiatal closure plus omentopexy and thoracic fixation of the left crus in patients undergoing robotic oesophagectomy at Beaumont RCSI Cancer Centre. Eligible adults with non-metastatic oesophageal cancer are randomised 1:1 and participants are blinded to allocation while surgeons are not. Outcomes include routine clinical follow-up and CT imaging at about 5–6 and 12 months to detect para-conduit hernia, with outcome assessors blinded where feasible. A standardised operative video is used to ensure consistent technique across intervention cases.
Why it matters
Potential benefit: If successful, routine hiatal closure with omentopexy and left-crus fixation could lower the rate of para-conduit hernias and reduce emergency reoperations after robotic oesophagectomy.
How similar studies have gone: Observational series and surgeon experience suggest hiatal closure may reduce para-conduit hernia, but randomised trial evidence is limited and this specific combined technique is not yet proven in RCTs.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: Age ≥ 18 years Diagnosis of oesophageal cancer Planned robotic oesophagectomy with curative intent No clinical or radiological evidence of distant metastases at time of recruitment Able to provide written informed consent Exclusion Criteria: Evidence of distant metastatic disease Not suitable for robotic oesophagectomy Inability to provide informed consent
Where it's running
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Beaumont RCSI Cancer Centre
Dublin, Beaumont, Ireland Recruiting
Study contacts
- Study coordinator: Prof Jarlath Bolger
- Email: jarbolger@rcsi.com
- Phone: +35318093000
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.