Robotic Versus Laparoscopic Surgery for Crohn's Disease: A Systematic Review and Meta-Analysis with Trial Sequential...

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Laparoscopic surgery is the standard for colorectal procedures.
• Robotic surgery's role in inflammatory bowel disease (IBD) is not well-established.
• Comparing robotic versus laparoscopic approaches in IBD is crucial.

Purpose of the Study:

• To compare the safety and efficacy of robotic surgery versus laparoscopic surgery for inflammatory bowel disease.
• To analyze postoperative complication rates, operative time, and hospital stay.
• To evaluate the current evidence on robotic surgery for Crohn's disease.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Cochrane Central Register.
• Meta-analysis of four observational studies involving 3776 patients.
• Random-effects models used for pooled odds ratios and mean differences.
• Trial sequential analysis (TSA) applied to assess evidence robustness.

Main Results:

• Robotic surgery was linked to significantly lower overall postoperative complications compared to laparoscopy (OR: 0.56).
• No significant differences were found in anastomotic leak, surgical site infection, or reoperation rates.
• Operative time was significantly longer for robotic surgery (MD: +51.8 minutes), while hospital stay was similar.

Conclusions:

• Robotic surgery appears safe and feasible for Crohn's disease, offering reduced overall complications.
• Longer operative times are noted with robotic surgery, but other perioperative outcomes are comparable.
• Further high-quality prospective studies are necessary to validate these findings.