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

Robot-assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (LS) are the main options for ileal ureteral replacement (IUR). It is not clear which option is superior. The purpose of this study is to compare RALS and LS for IUR.

We searched MEDLINE, Embase, Web of Science, Scopus, Cochrane Central, and Google Scholar for studies comparing RALS and LS for IUR. The outcomes of interest are operative time, blood loss, postoperative stay, and Clavien-Dindo complications. Meta-analysis was performed with Rev Man version 5.4.

We included 36 patients from 3 studies. The mean age was 44 years, with 53% male patients. Blood loss (MD -89.13 cc, CI -129.03 to -49.22, I² = 0%) was significantly lower in patients undergoing RALS when comparing with LS. No differences were observed when comparing operative time (MD -10.99 minutes, CI -85.66 to 63.59, p = 0.77, I² = 64%), postoperative stay (MD -2.56 days, CI -8.24 to 3.13, p = 0.38, I² = 30%), and postoperative complications (OR 1.63, CI 0.27 to 10.02, p = 0.60, I² = 0%).

Overall, we conclude that the robot-assisted technique showed less bleeding compared to the laparoscopic technique.