AIHTA - Publications - Search - Robot-assisted surgery in thoracic and visceral indications – Update 2023

Riegelnegg, M. and Gassner, L. and Grössmann-Waniek, N. (2023): Robot-assisted surgery in thoracic and visceral indications – Update 2023. HTA-Projektbericht 108/ Update 2023.

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Robot-assisted surgery is a minimally invasive procedure where instruments are controlled through a telemanipulator. This is intended to lead to higher dexterity compared to the human hand and the laparoscope, thus allowing for a higher level of precision. Robot-assisted procedures claim to enhance clinical outcomes and reduce healthcare resource utilisation when compared to open surgery or laparoscopy. The present report is an update of a systematic review from 2019, which investigated the effectiveness and safety of robot-assisted surgery compared to open surgery and conventional laparoscopy in thoracic and visceral indications.

For five out of the 14 procedures, no evidence could be identified. In total, 20 randomised controlled trials and five follow-up publications met the inclusion criteria. In most studies, relevant endpoints were either not reported, not measured, or did not show statistically significant differences. Regarding some endpoints (e.g. blood loss), robot-assisted procedures showed advantages, but these results were only shown by a few studies with low-quality evidence. As for the operation time, only conflicting results could be identified.

In general, robot-assisted surgery is associated with higher costs in terms of acquisition and maintenance compared to conventional procedures. Additionally, it is associated with an increased environmental impact due to higher greenhouse gas emissions and waste generation.

In conclusion, due to the heterogeneous results and the lack of evidence for a variety of study endpoints, a general statement about the effectiveness and safety of robot-assisted surgery is not possible. Furthermore, most of the extracted results did not support the claimed benefits of robot-assisted procedures.

Item Type:Project Report
Keywords:Robotic surgery, robot-assisted surgery, da Vinci, thoracic surgery, visceral surgery
Subjects:WB Practice of medicine > WB 300-962 Therapeutics
WF Respiratory system
WI Digestive system > WI 250 Oesophagus
WI Digestive system > WI 300-387 Stomach
WI Digestive system > WI 400-560 Intestines
WI Digestive system > WI 600-650 Anus. Rectum
WI Digestive system > WI 700-770 Liver. Billary tract
WI Digestive system > WI 800-830 Pancreas
WI Digestive system > WI 900-970 Abdomen
WJ Urogenital system > WJ 140-160 Urologic diseases
WJ Urogenital system > WJ 300-378 Kidney
WJ Urogenital system > WJ 400-600 Ureter. Bladder. Urethra
WJ Urogenital system > WJ 700-875 Male genitalia
WK Endocrine system > WK 700-790 Adrenal glands
WO Surgery > WO 500-517 Operative surgical procedures. Techniques
WO Surgery > WO 505 Minimally invasive surgical procedures
WX Hospitals and other health facilities > WX 200-225 Clinical departments and units
Series Name:HTA-Projektbericht 108/ Update 2023
Deposited on:18 Aug 2023 13:41
Last Modified:27 Sep 2023 09:41

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