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Surgical Endoscopy
Published in: Surgical Endoscopy 11/2018

01-11-2018 | Review Article

Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis

Authors: Caiwen Han, Xinyi Shan, Liang Yao, Peijing Yan, Meixuan Li, Lidong Hu, Hongwei Tian, Wutang Jing, Binbin Du, Lixia Wang, Kehu Yang, Tiankang Guo

Published in: Surgical Endoscopy | Issue 11/2018

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Abstract

Background

Robotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of RAC compared with LC for benign gallbladder disease.

Methods

A systematic literature search was conducted using the PubMed, EMBASE, and Cochrane Library databases (from their inception to December 2017) to obtain comparative studies assessing the safety and efficacy between RAC and LC. The quality of the literature was assessed, and the data analyzed using R software, random effects models were applied.

Results

Twenty-six studies, including 5 RCTs and 21 NRCSs (3 prospective plus 18 retrospective), were included. A total of 4004 patients were included, of which 1833 patients (46%) underwent RAC and 2171 patients (54%) underwent LC. No significant differences were found in intraoperative complications, postoperative complications, readmission rate, hospital stay, estimated blood loss, and conversion rate between RAC and LC groups. However, RAC was related to longer operative time compared with LC (MD = 12.04 min, 95% CI 7.26–16.82) in RCT group, which was consistent with NRCS group; RAC also had a higher rate of incisional hernia in NRCS group (RR = 3.06, 95% CI 1.42–6.57), and one RCT reported that RAC was similar to LC (RR = 7.00, 95% CI 0.38–129.84).

Conclusions

The RAC was not found to be more effective or safer than LC for benign gallbladder diseases, which indicated that RAC is a developing procedure instead of replacing LC at once. Given the higher costs, the current evidence is in favor of LC in cholecystectomy.
Appendix
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Metadata
Title
Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis
Authors
Caiwen Han
Xinyi Shan
Liang Yao
Peijing Yan
Meixuan Li
Lidong Hu
Hongwei Tian
Wutang Jing
Binbin Du
Lixia Wang
Kehu Yang
Tiankang Guo
Publication date
01-11-2018
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6295-9

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