TY - JOUR
T1 - Robotic cholecystectomy versus conventional laparoscopic cholecystectomy
T2 - a meta-analysis
AU - Huang, Yeqian
AU - Chua, Terence C.
AU - Maddern, Guy J.
AU - Samra, Jaswinder S.
PY - 2017/3
Y1 - 2017/3
N2 - Background: Robotic cholecystectomy is a novel approach that offers the surgeon improved high-definition, 3-dimensional views and enhanced instrument ergonomics, which represent a technical development from previous operative platforms that include conventional and single-incision laparoscopy. This review compares its short-term outcomes with conventional laparoscopic cholecystectomy by a meta-analysis. Methods: A literature search was conducted using the MEDLINE, EMBASE, and PubMed databases (January 1990–October 2015). Studies identified were appraised with standard selection criteria. Data were extracted and a meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Results: Thirteen studies, 12 retrospective trials and one randomized controlled trial comprising 1,589 patients (laparoscopic cholecystectomy, n = 921; robotic cholecystectomy, n = 668) were examined. There was a trend of a greater median total operative time (115.3 min vs 128.0 min; pooled MD = 31.22, 95% confidence interval = −2.48 to 59.96; Z = 2.13; P = .03) and preoperative time (32.4 min vs 53.4 min; pooled MD = 20.98, 95% confidence interval = 15.74 to 26.23; Z = 7.84; P < .001) in the robotic cholecystectomy group. Intraoperative complications (P = .52), conversion rate (P = .06), estimated blood loss (P = .55), postoperative complications (P = .28), duration of hospital stay (P = .36), and readmission rate (P = .85) were similar between both groups. Conclusion: Robotic cholecystectomy is associated with greater operative times related primarily to the preparatory phase of the operation but with similar safety and perioperative outcome as conventional laparoscopic cholecystectomy. For it to gain acceptance, future studies are required to define specific measures to quantify equipment benefits to the surgeon and to evaluate the potential advantage of its use in the acute setting. (Surgery 2017;161:628-36.)
AB - Background: Robotic cholecystectomy is a novel approach that offers the surgeon improved high-definition, 3-dimensional views and enhanced instrument ergonomics, which represent a technical development from previous operative platforms that include conventional and single-incision laparoscopy. This review compares its short-term outcomes with conventional laparoscopic cholecystectomy by a meta-analysis. Methods: A literature search was conducted using the MEDLINE, EMBASE, and PubMed databases (January 1990–October 2015). Studies identified were appraised with standard selection criteria. Data were extracted and a meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Results: Thirteen studies, 12 retrospective trials and one randomized controlled trial comprising 1,589 patients (laparoscopic cholecystectomy, n = 921; robotic cholecystectomy, n = 668) were examined. There was a trend of a greater median total operative time (115.3 min vs 128.0 min; pooled MD = 31.22, 95% confidence interval = −2.48 to 59.96; Z = 2.13; P = .03) and preoperative time (32.4 min vs 53.4 min; pooled MD = 20.98, 95% confidence interval = 15.74 to 26.23; Z = 7.84; P < .001) in the robotic cholecystectomy group. Intraoperative complications (P = .52), conversion rate (P = .06), estimated blood loss (P = .55), postoperative complications (P = .28), duration of hospital stay (P = .36), and readmission rate (P = .85) were similar between both groups. Conclusion: Robotic cholecystectomy is associated with greater operative times related primarily to the preparatory phase of the operation but with similar safety and perioperative outcome as conventional laparoscopic cholecystectomy. For it to gain acceptance, future studies are required to define specific measures to quantify equipment benefits to the surgeon and to evaluate the potential advantage of its use in the acute setting. (Surgery 2017;161:628-36.)
UR - http://www.scopus.com/inward/record.url?scp=85008219788&partnerID=8YFLogxK
U2 - 10.1016/j.surg.2016.08.061
DO - 10.1016/j.surg.2016.08.061
M3 - Article
C2 - 28011011
AN - SCOPUS:85008219788
SN - 0039-6060
VL - 161
SP - 628
EP - 636
JO - Surgery (United States)
JF - Surgery (United States)
IS - 3
ER -