Robotic versus conventional neck dissection: A systematic review and meta-analysis

Area of Science:

• Oncology
• Surgical Innovation
• Head and Neck Surgery

Background:

• Head and neck malignancies necessitate surgical intervention, often involving neck dissection.
• Conventional open neck dissection is a standard procedure with established outcomes.
• Robotic-assisted surgery presents a minimally invasive alternative with potential benefits.

Purpose of the Study:

• To systematically review and compare perioperative outcomes of robotic versus conventional neck dissection in head and neck cancer patients.
• To evaluate key metrics including nodal yield, recurrence, cosmetic results, operative time, length of stay, and complications.

Main Methods:

• Systematic review and meta-analysis of comparative studies.
• Searched PubMed, Web of Science, and EMBASE databases.
• Extracted data on nodal yield, recurrence, cosmesis, operative time, length of stay, and complications.

Main Results:

• Eleven studies (225 robotic, 430 open dissections) were included.
• Robotic surgery showed improved cosmesis but significantly longer operative times.
• No significant differences were found in total nodal yield, recurrence rates, or perioperative complications.

Conclusions:

• Robotic neck dissection offers comparable perioperative outcomes to conventional methods, with a notable increase in operative time.
• Superior cosmesis with robotic surgery requires cautious interpretation due to measurement tools and potential bias.
• Robotic surgery is a viable alternative, but increased operative time is a key consideration.