Robot-assisted versus laparoscopic ileal ureteral replacement: systematic review and meta-analysis

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Ileal ureteral replacement (IUR) is a complex reconstructive procedure.
• Robot-assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (LS) are primary surgical approaches for IUR.
• The comparative efficacy of RALS versus LS for IUR remains unclear.

Purpose of the Study:

• To compare the outcomes of robot-assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (LS) for ileal ureteral replacement (IUR).

Main Methods:

• A systematic literature search was conducted across multiple databases (MEDLINE, Embase, Web of Science, Scopus, Cochrane Central, Google Scholar).
• Studies comparing RALS and LS for IUR were identified.
• Meta-analysis was performed to evaluate operative time, blood loss, postoperative stay, and Clavien-Dindo complications.

Main Results:

• Thirty-six patients from three studies were included.
• Robot-assisted laparoscopic surgery (RALS) demonstrated significantly lower blood loss (MD -89.13 cc) compared to conventional laparoscopic surgery (LS).
• No significant differences were found in operative time, postoperative hospital stay, or the incidence of postoperative complications between RALS and LS.

Conclusions:

• Robot-assisted laparoscopic surgery (RALS) offers a significant advantage in reducing blood loss during ileal ureteral replacement (IUR) compared to conventional laparoscopic surgery (LS).
• Further research may be needed to fully elucidate long-term functional outcomes and cost-effectiveness.