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Meta-Analysis
. 2024 Nov 1;24(1):239.
doi: 10.1186/s12894-024-01632-3.

Valveless and conventional insufflation on pneumoperitoneum-related complications in robotic partial nephrectomy: a systematic review and meta-analysis of prospective studies

Lucas Schenk de Almeida  1 , Richard Dobrucki de Lima  1 , Breno Cordeiro Porto  1 , Carlo Camargo Passerotti  2 , Rodrigo Afonso da Silva Sardenberg  3 , José Pinhata Otoch  1 , José Arnaldo Shiomi da Cruz  4   5   6
Affiliations
Meta-Analysis

Valveless and conventional insufflation on pneumoperitoneum-related complications in robotic partial nephrectomy: a systematic review and meta-analysis of prospective studies

Lucas Schenk de Almeida et al. BMC Urol. .

Abstract

Introduction: The use of pneumoperitoneum is an essential step for performing laparoscopic and robotic surgery. Pneumoperitoneum insufflation can cause complications such as pneumothorax, subcutaneous emphysema, and pneumomediastinum. The purpose of this meta-analysis is to compare the safety of using the conventional insufflation system versus a Valveless insufflation system as devices for manufacturing pneumoperitoneum in robotic-assisted nephrectomy.

Methods: A comprehensive literature search was conducted on PUBMED, EMBASE, SCOPUS, and Cochrane, from inception until January 2024. Randomized and nonrandomized prospective studies were included in the meta-analysis, performed by the R+ Rstudio.

Results: Three publications encompassing 478 patients were included. We observed no difference in SCE (OR 0.60, CI 95% 0.27;1.34, p = 0.134, I2 = 0), PNM (OR 0.82, CI 95% 0.24;2.78, p = 0.558, I2 = 0), When comparing groups conventional insufflation system (CIS) versus AirSealTM insufflation system (AIS) with pneumoperitoneum pressure of 15 mmHg or 12 mmHg.

Conclusion: The presented data showed no difference between the AIS when compared with CIS in Pneumoperitoneum insufflation-related complications.

Keywords: Neumoperitoneum insufflation-related complications; Partial nephrectomy; Robot-assisted; Standard insufflation; Valveless.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prisma flow diagram
Fig. 2
Fig. 2
AirSeal versus Standard group pneumoperitoneum insufflation, no difference in SCE complication. A Forest plot of subcutaneous emphysema SCE (enfisema subcutâneo), CI, confidence
Fig. 3
Fig. 3
AirSeal versus Standard group pneumoperitoneum insufflation, no difference in PMS complication. A Forest plot of pneumomediastinum PMS (pneumomediastino), CI, confidence interval
Fig. 4
Fig. 4
Risk of bias of the included studies (ROBINS-1) and (ROB-2). Risk os bias (robins1). A Risk of bias summary for non-randomized studies (ROBINS-I). B Risk of bias summary for randomized studies (ROB-2). C Risk of bias summary for randomized studies (ROB-2)
See this image and copyright information in PMC

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