Evidence map›Paper›PMID 36323978›Full record

Trial reportSurgical endoscopy2023

Robotic eTEP versus IPOM evaluation: the REVEAL multicenter randomized clinical trial.

Clayton C Petro, Katherine C Montelione, Samuel J Zolin, David B Renton, Jonathan P Yunis, Michael P Meara, Adele Costanzo, Kayla Diaz, Kristen McKenzie, Melanie Wilber and 8 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 7 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 7 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  8. Trial
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  11. The effect of surgical approach on opioid prescription rates for outpatient ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026
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  19. Costing methodologies in robotic ventral hernia repair: a scoping review.Hernia : the journal of hernias and abdominal wall surgery · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 1 country.

Clayton C PetroDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA. PETROC@ccf.org.ORCID http://orcid.org/0000-0002-5523-2752
Katherine C MontelioneDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
Samuel J ZolinDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
David B RentonDepartment of Surgery, Center for Abdominal Core Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Jonathan P YunisCenter for Hernia Repair, Sarasota Memorial Hospital, Sarasota, FL, USA.
Michael P MearaDepartment of Surgery, Center for Abdominal Core Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Adele CostanzoDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
Kayla DiazDepartment of Surgery, Center for Abdominal Core Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Kristen McKenzieCenter for Hernia Repair, Sarasota Memorial Hospital, Sarasota, FL, USA.
Melanie WilberCenter for Hernia Repair, Sarasota Memorial Hospital, Sarasota, FL, USA.
Tamela FonsecaCenter for Hernia Repair, Sarasota Memorial Hospital, Sarasota, FL, USA.
Chao TuDepartment of Statistics, Cleveland Clinic Foundation, Cleveland, OH, USA.
Molly A OlsonDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
David M KrpataDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
Lucas R BeffaDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
Ben K PouloseDepartment of Surgery, Center for Abdominal Core Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Michael J RosenDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
Ajita S PrabhuDepartment of Surgery, Center for Abdominal Core Health, Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave. A-100, Cleveland, OH, 44195, USA.
Cleveland Clinic Lerner College of Medicine · USSarasota Memorial Hospital · USThe Ohio State University Wexner Medical Center · USCleveland Clinic · USCornell University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor small to medium-sized ventral hernias, robotic intraperitoneal onlay mesh (rIPOM) and enhanced-view totally extraperitoneal (eTEP) repair have emerged as acceptable approaches that each takes advantage of robotic instrumentation. We hypothesized that avoiding mesh fixation in a robotic eTEP repair offers an advantage in early postoperative pain compared to rIPOM.

methodsThis is a multi-center, randomized clinical trial for patients with midline ventral hernias ≤ 7 cm, who were randomized to rIPOM or robotic eTEP. The primary outcome was pain (0-10) on the first postoperative day. Secondary outcomes included same-day discharge, length of stay, opioid consumption, quality of life, surgeon workload, and cost.

resultsBetween November 2019 and November 2021, 100 patients were randomized (49 rIPOM, 51 eTEP) among 5 surgeons. Pain on the first postoperative day [median (IQR): 5 (4-6) vs. 5 (3.5-7), p = 0.66] was similar for rIPOM and eTEP, respectively, a difference maintained following adjustments for surgeon, operative time, baseline pain, and patient co-morbidities (difference 0.28, 95% CI - 0.63 to 1.19, p = 0.56). No differences in pain on the day of surgery, 7, and 30 days after surgery were identified. Same-day discharge, length of stay, opioid consumption, and 30-day quality of life were also comparable, though rIPOM required less surgeon workload (p < 0.001), shorter operative time [107 (86-139) vs. 165 (129-212) min, p < 0.001], and resulted in fewer surgical site occurrences (0 vs. 8, p = 0.004). The total direct costs for rIPOM and eTEP were comparable [$8282 (6979-11835) vs. $8680 (7550-10282), p = 0.52] as the cost savings for eTEP attributable to mesh use [$442 (434-485) vs. $69 (62-76), p =  < 0.0001] were offset by increased expenses for operative time [$669 (579-861) vs. $1075 (787-1367), p < 0.0001] and use of more robotic equipment [$760 (615-933) vs. $946 (798-1203), p = 0.001].

conclusionThe avoidance of fixation in a robotic eTEP repair did not reveal a benefit in postoperative pain to offset the shorter operative time and surgeon workload offered by rIPOM.

Indexed as

Hernia, VentralIncisional HerniaLaparoscopyRobotic Surgical ProceduresAnalgesics, OpioidHerniorrhaphyHumansPostoperative PainQuality of LifeSurgical MeshAnalgesics, OpioideTEPHerniaIPOMRetromuscularRoboticVentral

Identifiers

PMID36323978
OpenAlexW4308057184

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.