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Meta-Analysis
. 2024 Feb 26;19(2):e0298989.
doi: 10.1371/journal.pone.0298989. eCollection 2024.

Meta-analysis of the effectiveness and safety of robotic-assisted versus laparoscopic transabdominal preperitoneal repair for inguinal hernia

Xi Li  1 , Yue-Juan Li  1 , Hui Dong  1 , Deng-Chao Wang  1 , Jian Wei  1
Affiliations
Meta-Analysis

Meta-analysis of the effectiveness and safety of robotic-assisted versus laparoscopic transabdominal preperitoneal repair for inguinal hernia

Xi Li et al. PLoS One. .

Abstract

Background: Inguinal hernia is a common global disease. This study aims to investigate the effectiveness and safety of robot-assisted transabdominal preperitoneal repair (RTAPP) and laparoscopic transabdominal preperitoneal repair (LTAPP) for inguinal hernia.

Methods: We conducted a thorough search in Cochrane Library, Embase, and PubMed for relevant clinical studies. After applying inclusion and exclusion criteria, the quality of selected studies was assessed using the Jadad scale for randomized controlled studies and the Newcastle-Ottawa scale for observational studies. Meta-analysis was performed using RevMan 5.3 software.

Results: A total of ten studies were included, comprising two randomized controlled studies and eight non-randomized controlled studies. Meta-analysis results revealed no statistically significant differences between the RTAPP group and the LTAPP group regarding hospital stay [MD = 0.21 days, 95% CI (-0.09, 0.51), P = 0.17], incidence of seroma [OR = 0.85, 95% CI(0.45, 1.59), P = 0.61], overall complication rate [OR = 1.22, 95% CI(0.68, 2.18), P = 0.51], readmission rate [OR = 1.31, 95% CI(0.23, 7.47), P = 0.76], and recurrence rate [OR = 0.82, 95% CI(0.22, 3.07), P = 0.77]. However, the RTAPP group had longer operation time compared to the LTAPP group [MD = 14.02 minutes, 95% CI (6.65, 21.39), P = 0.0002], and the cost of the RTAPP procedure was higher than that of the LTAPP procedure [MD = $4.17 thousand, 95% CI (2.59, 5.76), P<0.00001].

Conclusion: RTAPP for inguinal hernia is a safe and feasible approach, however, it is associated with increased operation time and treatment costs.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study selection.
Fig 2
Fig 2. Forest plot comparing the operation time between the two groups.
Fig 3
Fig 3. Forest plot comparing the hospital stay between the two groups.
Fig 4
Fig 4. Forest plot comparing the cost between the two groups.
Fig 5
Fig 5. Forest plot comparing the incidence of seroma between the two groups.
Fig 6
Fig 6. Forest plot comparing the overall complication rate between the two groups.
Fig 7
Fig 7. Forest plot comparing the readmission rate between the two groups.
Fig 8
Fig 8. Forest plot comparing the recurrence rate between the two groups.
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