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Case Reports
. 2023 Apr;17(2):313-324.
doi: 10.1007/s11701-022-01453-2. Epub 2022 Sep 8.

A systematic review of robot-assisted anti-reflux surgery to examine reporting standards

Marc M Huttman  1   2 , Harry F Robertson  3 , Alexander N Smith  4 , Sarah E Biggs  5 , Ffion Dewi  5 , Lauren K Dixon  1   5 , Emily N Kirkham  1   6 , Conor S Jones  1   7 , Jozel Ramirez  1   5 , Darren L Scroggie  1 , Benjamin E Zucker  1   5 , Samir Pathak  1   8 , Natalie S Blencowe  9 ; RoboSurg collaborative group
Collaborators, Affiliations
Case Reports

A systematic review of robot-assisted anti-reflux surgery to examine reporting standards

Marc M Huttman et al. J Robot Surg. 2023 Apr.

Abstract

Robot-assisted anti-reflux surgery (RA-ARS) is increasingly being used to treat refractory gastro-oesophageal reflux disease. The IDEAL (Idea, Development, Exploration, Assessment, Long-term follow up) Collaboration's framework aims to improve the evaluation of surgical innovation, but the extent to which the evolution of RA-ARS has followed this model is unclear. This study aims to evaluate the standard to which RA-ARS has been reported during its evolution, in relation to the IDEAL framework. A systematic review from inception to June 2020 was undertaken to identify all primary English language studies pertaining to RA-ARS. Studies of paraoesophageal or giant hernias were excluded. Data extraction was informed by IDEAL guidelines and summarised by narrative synthesis. Twenty-three studies were included: two case reports, five case series, ten cohort studies and six randomised controlled trials. The majority were single-centre studies comparing RA-ARS and laparoscopic Nissen fundoplication. Eleven (48%) studies reported patient selection criteria, with high variability between studies. Few studies reported conflicts of interest (30%), funding arrangements (26%), or surgeons' prior robotic experience (13%). Outcome reporting was heterogeneous; 157 distinct outcomes were identified. No single outcome was reported in all studies.The under-reporting of important aspects of study design and high degree of outcome heterogeneity impedes the ability to draw meaningful conclusions from the body of evidence. There is a need for further well-designed prospective studies and randomised trials, alongside agreement about outcome selection, measurement and reporting for future RA-ARS studies.

Keywords: Anti-reflux surgery; Fundoplication; IDEAL framework; Outcome reporting; Robotic surgery.

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Conflict of interest statement

This study was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the National Institute for Health Research, or the Department of Health. NB is a Medical Research Council Clinician Scientist.

Figures

Fig. 1
Fig. 1
PRIMSA diagram showing selection of articles for review
Fig. 2
Fig. 2
Bar chart showing the publication dates and IDEAL stages of included studies
Fig. 3
Fig. 3
Diagram displaying all reported outcomes across all included studies
Fig. 4
Fig. 4
Bar chart showing papers’ reported outcomes by IDEAL stage
See this image and copyright information in PMC

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