The evidence behind robot-assisted abdominopelvic surgery: a meta-analysis of randomized controlled trials

Jae Hwan Choi, Abdul Rahman Diab, Katherine Tsay, Davis Kuruvilla, Samer Ganam, Adham Saad, Salvatore Docimo, Joseph A. Sujka, Christopher G. DuCoin

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Despite recent advancements, the advantage of robotic surgery over other traditional modalities still harbors academic inquiries. We seek to take a recently published high-profile narrative systematic review regarding robotic surgery and add meta-analytic tools to identify further benefits of robotic surgery. Methods: Data from the published systematic review were extracted and meta-analysis were performed. A fixed-effect model was used when heterogeneity was not significant (Chi2p ≥ 0.05, I2 ≤ 50%) and a random-effects model was used when heterogeneity was significant (Chi2p < 0.05, I2 > 50%). Forest plots were generated using RevMan 5.3 software. Results: Robotic surgery had comparable overall complications compared to laparoscopic surgery (p = 0.85), which was significantly lower compared to open surgery (odds ratio 0.68, p = 0.005). Compared to laparoscopic surgery, robotic surgery had fewer open conversions (risk difference − 0.0144, p = 0.03), shorter length of stay (mean difference − 0.23 days, p = 0.01), but longer operative time (mean difference 27.98 min, p < 0.00001). Compared to open surgery, robotic surgery had less estimated blood loss (mean difference − 286.8 mL, p = 0.0003) and shorter length of stay (mean difference − 1.69 days, p = 0.001) with longer operative time (mean difference 44.05 min, p = 0.03). For experienced robotic surgeons, there were less overall intraoperative complications (risk difference − 0.02, p = 0.02) and open conversions (risk difference − 0.03, p = 0.04), with equivalent operative duration (mean difference 23.32 min, p = 0.1) compared to more traditional modalities. Conclusion: Our study suggests that compared to laparoscopy, robotic surgery may improve hospital length of stay and open conversion rates, with added benefits in experienced robotic surgeons showing lower overall intraoperative complications and comparable operative times.

Original languageEnglish
Pages (from-to)2371-2382
Number of pages12
JournalSurgical Endoscopy and Other Interventional Techniques
Volume38
Issue number5
Early online date25 Mar 2024
DOIs
StatePublished - May 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

Keywords

  • Meta-analysis
  • Minimally invasive surgery
  • Robotic surgery
  • Systematic review

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