Comparison Between Robotic and Laparoscopic or Open Anastomoses: A Systematic Review and Meta-Analysis

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Comparative Effectiveness Research

Background:

• Robotic surgery is increasingly utilized for creating surgical anastomoses.
• A comprehensive analysis of robotic anastomoses compared to traditional methods is warranted.

Purpose of the Study:

• To systematically review and meta-analyze outcomes of robotic anastomoses.
• To compare robotic anastomoses with laparoscopic and open approaches across various surgical procedures.

Main Methods:

• Systematic review of studies published up to June 2019.
• Inclusion of studies reporting on hand-sewn anastomoses for specific procedures.
• Exclusion of studies with stapled anastomoses or extracorporeal techniques.

Main Results:

• Robotic anastomoses demonstrated comparable rates of anastomotic leak and stricture to laparoscopic and open methods.
• Significantly lower stenosis rates were observed in robotic Roux-en-Y gastric bypass (RYGB) and radical prostatectomy compared to laparoscopic and open approaches, respectively.
• Robotic renal transplantation required longer operative times compared to the open approach.

Conclusions:

• Robotic anastomoses generally yield outcomes equivalent to laparoscopic and open techniques.
• Specific procedures like RYGB and radical prostatectomy show advantages with robotic assistance regarding stenosis.
• Operative time remains a consideration for robotic renal transplantation.