Robotic abdominopelvic surgery: a systematic review of cross-platform outcomes.


Journal

Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401

Informations de publication

Date de publication:
29 Oct 2024
Historique:
received: 12 08 2024
accepted: 14 10 2024
medline: 29 10 2024
pubmed: 29 10 2024
entrez: 29 10 2024
Statut: epublish

Résumé

As the global surgical robotic ecosystem diversifies, multi-platform surgery is becoming increasingly common. The natural question is whether these robots differ in performance and cost. We address this question and report the first systematic review comparing platforms. A systematic search identified clinical studies comparing at least two platforms. Of 287 studies, 31 were included, with 5 RCTs and 26 cohort studies, including 3624 patients. All studies compared da Vinci with Hintori, Hugo, KangDuo, Micro-Hand, Revo-I, Senhance, and Versius robots. Comparisons were across specialties: urology (18 studies; upper and lower tract), general surgery (11 studies; inguinal and ventral hernia, cholecystectomy, colorectal, pancreatic, oesophagectomy, distal gastrectomy), gynaecology (3 studies; hysterectomy, sacrocolpopexy). There were no differences in conversion rate, estimated blood loss, complication rate, pathological parameters, oncological outcomes (6 months), and functional outcomes (12 months). Results were mixed on operative time and its components. Length of stay was largely similar. Surgeon task load was similar (2 studies). Operative cost was 45-60% lower on the newer platforms (3 studies). Operative, clinical, oncological, and functional outcomes were similar for da Vinci and the newer robots across a range of abdominopelvic procedures, with a signal of lower cost on newer types. Studies were heterogeneous. Data on non-technical skills, other human factors, and comparative learning curves was scant. The majority of evidence was low quality and retrospective. However, accumulating evidence on safety, efficacy, and non-inferiority of the newer platforms has implications for robotic training programmes and procurement.

Identifiants

pubmed: 39470929
doi: 10.1007/s11701-024-02144-w
pii: 10.1007/s11701-024-02144-w
doi:

Types de publication

Systematic Review Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

386

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

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Auteurs

Atanu Pal (A)

Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. atanu.pal@doctors.org.uk.

Rehan Gamage (R)

Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

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