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Robot-assisted versus conventional endoscopic submucosal dissection: a systematic review and meta-analysis
Menghan Wang1, Yan Zhao1, Yijun Chen1
1Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Beijing, China.
Robot-assisted endoscopic submucosal dissection (RA-ESD) shows improved efficiency and reduced difficulty compared to conventional ESD (C-ESD). Further clinical studies are needed to confirm these preliminary findings in real-world settings.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Robotics in Medicine
Background:
- Robot-assisted endoscopic submucosal dissection (RA-ESD) aims to overcome limitations of conventional ESD (C-ESD).
- Current evidence for RA-ESD is limited, primarily from preclinical studies.
Purpose of the Study:
- To systematically evaluate and compare the efficacy and safety of RA-ESD versus C-ESD.
- To synthesize existing evidence through a meta-analysis.
Main Methods:
- Systematic review and meta-analysis of comparative studies.
- Literature search conducted in major electronic databases adhering to PRISMA 2020 guidelines.
- Pooled continuous outcomes using mean differences and dichotomous outcomes using odds ratios with random-effects models.
Main Results:
- RA-ESD was associated with significantly shorter dissection and overall procedure times.
- Higher dissection speed and en bloc resection rates were observed with RA-ESD.
- RA-ESD demonstrated a lower rate of blind dissection and reduced risk of muscular injury, with no significant difference in perforation rates.
Conclusions:
- RA-ESD presents promising technical advantages over C-ESD, including enhanced efficiency and reduced difficulty.
- Preliminary findings suggest RA-ESD may improve procedural outcomes without increasing major adverse events.
- Further high-quality clinical studies are essential to validate the real-world effectiveness and safety of RA-ESD.
