Limited Evidence for Robot-assisted Surgery

Abstract

At this point there is not enough evidence to support the significantly higher costs with the implementation of robot-assisted surgery.

Robot-assisted laparoscopic surgery versus conventional laparoscopic surgery in randomized controlled trials: A systematic review and meta-analysis

“…Bias assessments of RCTs in previous reviews [ 1 , 16 – 18 , 51 – 56 ] differed according to the judgements of the authors reviewing the same studies. Bias assessments of RCTs in previous reviews have been typically performed in terms of random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other biases.…”

“…This kind of discrepancy could be found frequently among meta-analyses. Thus, our quality assessments ( Fig 2 ) were performed rather conservatively with a blank space for denoting unclear risk in consideration of previous assessments [ 1 , 16 – 18 , 51 – 56 ]. The risk of bias in the RCT was high and unclear overall.…”

“…The scope of meta-analyses exclusively on RCTs [ 1 , 16 , 17 ] considers only a specific surgical procedure to convey more homogenous statistical results, compared to the that of a meta-analysis across surgical procedures [ 18 ]. However, the intrinsic properties of robotic instruments throughout overall surgical procedures could be mistakenly reported as the results of the unique properties of the particular surgical procedure.…”

“…However, the intrinsic properties of robotic instruments throughout overall surgical procedures could be mistakenly reported as the results of the unique properties of the particular surgical procedure. In contrast, the scope of meta-analysis [ 18 ] has been enlarged to combine RCTs across surgical procedures. Nonetheless, this regrettably omitted, among others, cholecystectomy and did not present forest plots with subgroup analyses.…”

Robot-assisted surgical treatment in a case of superior mesenteric artery syndrome

“…The study concluded that RAS was not worth the significantly higher cost at the time. 15 Furthermore, there are still problems with RAS systems. A 2008 review of the United States Food and Drug Administration (US FDA) Manufacturer and User Facility Device Experience Database (MAUDE) found a total of 189 device failures between January 1, 2000 and August 27, 2007, of which 4.8% (9 cases) were associated with patient injury causing harm.…”