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Meta-Analysis
. 2021 Jun;35(6):2440-2456.
doi: 10.1007/s00464-020-08283-z. Epub 2021 Apr 21.

Robotic bariatric surgery for the obesity: a systematic review and meta-analysis

Zhengchao Zhang  1   2 , Lele Miao  1   2 , Zhijian Ren  1   2 , Yumin Li  3   4
Affiliations
Meta-Analysis

Robotic bariatric surgery for the obesity: a systematic review and meta-analysis

Zhengchao Zhang et al. Surg Endosc. 2021 Jun.

Abstract

Objective: The aim of this meta-analysis is to evaluate the safety and efficacy of bariatric surgery (BS) in patients with obesity by robotic bariatric surgery (RBS) compared with laparoscopic bariatric surgery (LBS).

Methods: The study was performed through searching in Pubmed, Web of Science, Embase database and Cochrane Library until March 31, 2020 comparing RBS with LBS. Data were calculated on the following endpoints: operative time, length of hospital stay, reoperation within 30 days, overall complications, leak, stricture, pulmonary embolisms, estimated blood loss and mortality. Data as relative risks (OR), or weighted mean difference (WMD) were summarized with 95% confidence interval (CI). Risk of publication bias was assessed through standard methods.

Results: Thirty eligible trials including 7,239 robotic and 203,181 laparoscopic surgery cases showed that RBS was referred to attain longer operative time [WMD = 27.61 min; 95%CI (16.27-38.96); P < 0.01] and lower mortality [OR 2.40; 95% CI (1.24-4.64); P = 0.009] than LBS. Length of hospital stay [WMD = - 0.02; 95% CI (- 0.19-0.15); P = 0.819], reoperation within 30 days [OR 1.36; 95% CI (0.65-2.82); P = 0.411], overall complications [OR 0.88; 95% CI (0.68-1.15); P = 0.362], leak [OR 1.04; 95% CI (0.43-2.51); P = 0.933], stricture [OR 1.05; 95% CI (0.52-2.12); P = 0.895], pulmonary embolisms [OR 1.97; 95% CI (0.93-4.17); P = 0.075], estimated blood loss[WMD = - 1.93; 95% CI (- 4.61-0.75); P = 0.158] were almost similar in both RBS group and LBS group. Three was no statistically significant difference between RRYGB and LRYGB in EWL%, no statistical significance between RSG and LSG after 1 year, 2 years and 3 years.

Conclusion: RBS presented lower mortality within 90 days and longer operative time in this meta-analysis with similar safety and efficacy for the obesity compared with LBS in other outcomes. Additionally, RBS might be beneficial in the future if it would be evaluated in comprehensive and long-term endpoints.

Keywords: Bariatric surgery; Laparoscopic; Meta-analysis; Obesity; Robotic.

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