Robotic vs laparoscopic approaches of pancreatic resection: a systematic review and meta-analysis

Pancreatic resection is necessary to treat pancreatic diseases, especially malignancy. Minimally invasive procedures, including robotic (RPR) and laparoscopic (LPR) pancreatic resections, have grown in popularity due to their potential to improve recovery and lower morbidity. The aim of this study is to provide evidence-based data for clinical decision-making by systematically comparing RPR and LPR with respect to postoperative recovery, perioperative safety, and oncological outcomes. A systematic review and meta-analysis following PRISMA guidelines was conducted using PubMed, Google Scholar, Cochrane, and Web of Science. Two independent reviewers extracted data, and pooled prevalence was analyzed using a random-effects model. Heterogeneity was assessed with Higgins I² and Cochran's Q test. A sensitivity analysis was done using R. Forty-six peer-reviewed articles with follow-up periods ranging from 3 to 288 months were included in this review. Robotic surgery was performed in 4.8%-67.6% of cases, with patient ages ranging from 30 to 70 years. A considerably shorter hospital stay (MD: - 0.72, P = 0.004) and a higher rate of conversion to open surgery (OR: 0.52, P < 0.00001) were associated with RPR. However, no significant differences were observed between RPR.and LPR in important outcomes, including resection rate, lymph node yield, overall complications, operating time, 90-day mortality, and postoperative complications. While RPR outperforms LPR in terms of conversion and hospital stay rates, it is not significantly superior in terms of oncological outcomes and morbidity rate. The high heterogeneity in the studies suggests the need for more research to determine the optimal minimally invasive technique for pancreatic surgery.