Robotic Platforms Not Superior for Abdominopelvic Surgery

For adults undergoing abdominopelvic surgery, robot-assisted surgery currently offers no clear advantage over laparoscopy or open surgery, and it increases operative duration compared with laparoscopy, according to a systematic review published online June 29 in the Annals of Internal Medicine.

Naila H. Dhanani, M.D., from McGovern Medical School at UTHealth in Houston, and colleagues examined the quality of evidence and outcomes of robot-assisted surgery compared with laparoscopy and open surgery in a review of 50 studies with 4,898 patients undergoing abdominopelvic surgery.

The researchers found that four (10 percent) of the 39 studies that reported incidence of Clavien-Dindo complications showed fewer complications with robot-assisted surgery. No difference was seen in intraoperative complications, conversion rates, or long-term outcomes in the majority of studies. Compared with laparoscopy, robot-assisted surgery had longer operative duration, but no obvious difference was seen compared with open surgery.

"Robot-assisted surgery has established itself as safe and effective but has not yet shown clear clinical benefit over either laparoscopy or open surgery. It comes at a substantial economic price and with significantly longer operative duration," the authors write. "However, with increased competition, improved technology and cost, and greater overall experience, robot-assisted surgery has the potential to evolve into a transformative innovation."