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Updated: Jul 12, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Five-year outcomes of the PROVE-IT randomized controlled trial: Patient-Reported Outcomes of Robotic vs. Laparoscopic
Erika M Schmidt1, William C Bennett2, Noah X Tocci2
1Cleveland Clinic Foundation, Center for Abdominal Core Health, 9500 Euclid Ave, A10-133, Cleveland, OH, 44195, USA. schmide7@ccf.org.
Background:
The Patient-Reported Outcomes of Robotic vs. Laparoscopic Ventral Hernia Repair with Intraperitoneal Mesh (PROVE-IT) randomized controlled trial previously demonstrated comparable pain at 1 year postoperatively between laparoscopic (lapIPOM) and robotic (rIPOM) approaches, although with potential differences in quality of life and recurrence. We aim to report 5-year follow-up of the PROVE-IT trial.
Methods:
All patients previously enrolled in PROVE-IT, a registry-based randomized controlled trial published in October 2020, were reviewed. Outcomes including hernia-specific quality of life (Hernia-Related Quality-of-Life Survey [HerQLes]), pain intensity (Patient-Reported Outcomes Measurement Information System [PROMIS 3a]), patient-reported bulging (Hernia Recurrence Inventory [HRI]), clinical hernia recurrences, and reoperations were analyzed.
Results:
Median time to clinical follow-up was 65 months [interquartile range (IQR) 56, 71]. Patient-reported outcomes were obtained for 49 of 75 patients (26 lapIPOM, 23 rIPOM). Clinical follow-up (physical exam and/or cross-sectional imaging) was completed for 64 of 75 patients (30 lapIPOM, 34 rIPOM). Median HerQLes and PROMIS 3a scores were 92 [IQR 68, 99] and 31 [IQR 31, 31] in the laparoscopic group and 92 [IQR 78, 95] and 31 [IQR 31, 31] in the robotic group (p = 0.91 and p = 0.86, respectively). Patient-reported bulging rates were 27% (lapIPOM) and 30% (rIPOM), p = 1.00. Clinical recurrence rates were 10% (n = 3) in the laparoscopic group and 24% (n = 8) in the robotic group, p = 0.27. Of fourteen abdominal reoperations (8 lapIPOM, 6 rIPOM, p = 0.57), two laparoscopic patients required elective reoperation for recurrence and no patients required mesh excision. There were no reoperations for recurrence in the robotic group.
Conclusions:
In this exploratory analysis, postoperative quality of life, pain intensity, recurrence, and reoperation rates were found to be comparable between laparoscopic and robotic IPOMs at 5 years.