Robotic versus laparoscopic general surgery in the emergency setting: a systematic review.

Autor: Anyomih TTK; Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; Ipswich Hospital Department of Surgery, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK., Mehta A; Department of Surgery, St George's Hospital, London, UK. alokmehta901@gmail.com., Sackey D; Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana., Woo CA; Department of Surgery, Huddersfield Royal Infirmary, Huddersfield, UK., Gyabaah EY; Department of Surgery, Sunyani Teaching Hospital, Sunyani, Ghana., Jabulo M; Ipswich Hospital Department of Surgery, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK., Askari A; Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, UK.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2024 Jul 05; Vol. 18 (1), pp. 281. Date of Electronic Publication: 2024 Jul 05.
DOI: 10.1007/s11701-024-02016-3
Abstrakt: Robot-assisted general surgery, an advanced technology in minimally invasive procedures, is increasingly employed in elective general surgery, showing benefits over laparoscopy in specific cases. Although laparoscopy remains a standard approach for common acute abdominal conditions, the role of robotic surgery in emergency general surgery remains uncertain. This systematic review aims to compare outcomes in acute general surgery settings for robotic versus laparoscopic surgeries. A PRISMA-compliant systematic search across MEDLINE, EMBASE, Science Citation Index Expanded, and the Cochrane Library was conducted. The literature review focused on articles comparing perioperative outcomes of emergency general surgery managed laparoscopically versus robot-assisted. A descriptive analysis was performed, and outcome measures were recorded. Six articles, involving 1,063 patients, compared outcomes of robotic and laparoscopic procedures. Two articles covered cholecystectomies, while the others addressed ileocaecal resection, subtotal colectomy, hiatal hernia and repair of perforated gastrojejunal ulcers. The level of evidence was low. Laparoscopic bowel resection in patients with inflammatory bowel disease (IBD) had higher complications; no significant differences were found in complications for other operations. Operative time showed no differences for cholecystectomies, but robotic approaches took longer for other procedures. Robotic cases had shorter hospital length of stay, although the associated costs were significantly higher. Perioperative outcomes for emergency robotic surgery in selected general surgery conditions are comparable to laparoscopic surgery. However, recommending robotic surgery in the acute setting necessitates a well-powered large population study for stronger evidence.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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