Comparative meta-analysis of perioperative outcomes following robot-assisted renal surgery: KangDuo versus Da Vinci...

The purpose of this study was to evaluate the safety and efficacy of perioperative outcomes of the KangDuo Surgical Robot System versus the Da Vinci System in robot-assisted renal surgery. We conducted a comprehensive systematic search in key databases including PubMed, the Cochrane Library, Embase, and Web of Science, encompassing studies in all languages, with the final search date being October 2025. We also excluded articles comprising reviews, letters, and single-arm studies. Variables were assessed using metrics of Weighted Mean Difference (WMD), Standardized Mean Difference (SMD), and Odds Ratio (OR). The statistical synthesis of the data, encompassing diverse outcome measures, was conducted utilizing the Review Manager software. Moreover, the protocol for this systematic review and meta-analysis is publicly available on PROSPERO (Registration number: CRD420251181530). In a pooled analysis of 370 participants from five trials, the KangDuo Surgical Robot System demonstrated a significantly extended docking time relative to the Da Vinci System (SMD = 1.55, 95% CI: 1.21-1.90; p < 0.00001). Conversely, comparisons of operative time, estimated blood loss, incidence of minor complications, ischemia time, and postoperative renal function (assessed by 4-week serum creatinine and eGFR) yielded comparable results, with no statistically significant differences. In this meta-analysis with limited sample size, geographic focus on Chinese centers, and short-term follow-up, the pooled data indicate that the KangDuo (KD) Surgical Robot System achieved non-inferiority to the Da Vinci System on several key perioperative metrics in robot-assisted renal surgery, although with a longer docking time. These findings support the KD system as a promising alternative in comparable settings, yet they should be interpreted within the constraints of the available evidence. Future research, particularly large-scale, multicenter randomized trials with long-term monitoring of survival and renal function, is necessary to confirm its efficacy and safety profile for widespread clinical adoption.