Robotics versus open surgery: the impact on cytokine release and patient outcomes

Surgical techniques have witnessed a significant evolution with the advent of robotic surgery. The impact of robotic surgery on the body's immune system, specifically its role in causing cytokine storm has gained interest. The present narrative review explores the association between robotic surgery and cytokine release in the body and attempts to contrast it with open surgical technique consequently, highlighting the impact on patient outcomes. A literature review was conducted using PubMed, Embase, Google Scholar, Web of Science and Cochrane databases. Screening was done using the keywords "Robotic Surgery," "Robot Assisted Surgery," "Conventional Surgery," "Cytokine," "Tissue Injury," "Inflammatory Response," and "IL-6." A total of 5379 articles were identified in the literature search out of which 5172 article records were excluded after the title and abstract screening that was done by two independent reviewers. 207 full text articles were assessed for eligibility and 154 were excluded. Finally, 53 articles were used as a core for this review article. Robotic surgery has been found to have a lower cytokine response and improved clinical outcomes in comparison to the open approach. It is crucial to consider the confounding factors when evaluating the postoperative outcomes that could affect the relationship between the surgical approach, cytokine release and clinical outcomes.