To evaluate available evidence on robot-assisted surgery compared with open and laparoscopic surgery.
The databases Medline, Embase, and Cochrane Library were systematically searched for randomized controlled trials comparing robot-assisted surgery with open and laparoscopic surgery regardless of surgical procedure. Meta-analyses were performed on each outcome with appropriate data material available. Cochrane Collaboration’s tool for assessing risk of bias was used to evaluate risk of bias on a study level. The GRADE approach was used to evaluate the quality of evidence of the meta-analyses.
This review included 20 studies comprising 981 patients. The meta-analyses found no significant differences between robot-assisted and laparoscopic surgery regarding blood loss, complication rates, and hospital stay. A significantly longer operative time was found for robot-assisted surgery. Open versus robot-assisted surgery was investigated in 3 studies. A lower blood loss and a longer operative time were found after robot-assisted surgery. No other difference was detected.
At this point there is not enough evidence to support the significantly higher costs with the implementation of robot-assisted surgery.
Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev, Denmark
The authors declare no conflicts of interest.
Reprints: Malene Broholm, BSc, Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark (e-mail: firstname.lastname@example.org).
Received May 11, 2015
Accepted December 14, 2015