No Clear Advantage to Robot-Assisted Abdominopelvic Surgery Over Conventional Surgery

By Reuters Staff

June 29, 2021

NEW YORK (Reuters Health) - A literature review has found "no clear advantage" to performing abdominopelvic surgery with currently available robotic platforms, which are costly and increase operation times, researchers report.

"Robot-assisted surgery has established itself as safe and effective but has not yet shown clear clinical benefit over either laparoscopy or open surgery (and) it comes at a substantial economic price and with significantly longer operative duration," Dr. Naila Dhanani of McGovern Medical School at UTHealth in Houston and colleagues write in Annals of Internal Medicine.

They reviewed 50 randomized controlled trials including nearly 4,900 patients to evaluate the quality of evidence and outcomes for robot-assisted abdominopelvic surgery compared with laparoscopy, open surgery, or both.

Most of the studies showed no difference in intraoperative complications, rates of conversion to open surgery, or long-term outcomes. However, robot-assisted surgery took longer to do than laparoscopy, but with no obvious difference with open surgery, the researchers report.

"Although proponents have argued that robot-assisted surgery is beneficial for the patient, the provider, and the health care system, this systematic review did not find evidence to support this. However, this review did show that robot-assisted surgery was largely safe and feasible across all measured outcomes," they write.

"With refinement, competition, and cost reduction, future versions have the potential to improve clinical outcomes," they add.

"The true value of robot-assisted surgery may lie in its future. The merger of robot-assisted surgery with data acquisition, artificial intelligence, and virtual reality-based platforms may allow it to achieve the distinction of disruptive innovation it currently promotes," they conclude.

The study had no specific funding.

SOURCE: Annals of Internal Medicine, online June 28, 2021.