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Review
. 2023 Jan 27;13(2):231.
doi: 10.3390/jpm13020231.

Robotic Surgery and Functional Esophageal Disorders: A Systematic Review and Meta-Analysis

Sara Vertaldi  1 , Anna D'Amore  1 , Michele Manigrasso  2 , Pietro Anoldo  2 , Alessia Chini  1 , Francesco Maione  1 , Marcella Pesce  1 , Giovanni Sarnelli  1 , Giovanni Domenico De Palma  1 , Marco Milone  1
Affiliations
Review

Robotic Surgery and Functional Esophageal Disorders: A Systematic Review and Meta-Analysis

Sara Vertaldi et al. J Pers Med. .

Abstract

The functional disease of the esophago-gastric junction (EGJ) is one of the most common health problems. It often happens that patients suffering from GERD need surgical management. The laparoscopic fundoplication has been considered the gold standard surgical treatment for functional diseases of the EGJ. The aim of our meta-analysis is to investigate functional outcomes after robotic fundoplication compared with conventional laparoscopic fundoplication. A prospective search of online databases was performed by two independent reviewers using the search string "robotic and laparoscopic fundoplication", including all the articles from 1996 to December 2021. The risk of bias within each study was assessed with the Cochrane ROBINS-I and RoB 2.0 tools. Statistical analysis was performed using Review Manager version 5.4. In addition, sixteen studies were included in the final analysis, involving only four RCTs. The primary endpoints were functional outcomes after laparoscopic (LF) and robotic fundoplication (RF). No significant differences between the two groups were found in 30-day readmission rates (p = 0.73), persistence of symptomatology at follow-up (p = 0.60), recurrence (p = 0.36), and reoperation (p = 0.81). The laparoscopic fundoplication represents the gold standard treatment for the functional disease of the EGJ. According to our results, the robotic approach seems to be safe and feasible as well. Further randomized controlled studies are required to better evaluate the advantages of robotic fundoplication.

Keywords: functional outcomes; hiatal hernia; laparoscopic fundoplication; reflux; robotic fundoplication.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram.
Figure 2
Figure 2
Summary of risk of bias for RCT studies [27,32,33,34].
Figure 3
Figure 3
Summary of risk of bias for non-RCT studies [22,23,24,25,26,28,29,30,31,35,36,37].
Figure 4
Figure 4
Forest plot of laparoscopic vs. robotic 30day readmission rates [22,23,25,26,33,35,37].
Figure 5
Figure 5
Forest plot of laparoscopic vs. robotic persistence of symptomatology [22,24,25,27,29,31,33,34,35,36,37].
Figure 6
Figure 6
Forest plot of laparoscopic vs. robotic recurrence of reflux symptoms [22,24,25,27,30,31,33,34,37].
Figure 7
Figure 7
Forest plot of laparoscopic vs. robotic reoperation rates [22,25,27,30,33,34,36,37].
See this image and copyright information in PMC

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