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Authors:
Taslim Aboudou, Meixuan Li, Wence Zhou, Zeliang Zhang, Shizhong Wang, Kehu Yang, China
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Abstract:
Background:
Surgical
robots operations is an emerging technology that offers many advantages in
conducting complex endoscopic procedures. However, robot-assisted inguinal
hernia repair generates controversies compared to laparoscopic inguinal hernia
repair. We evaluated the safety and efficiency of robot-assisted inguinal
hernia repair compared to the laparoscopic.Methods:
The Pub Med, EMBASE, and
Cochrane Library databases was carried out to obtain studies that comparatively
evaluated the efficacy, safety, and the economy between robot-assisted and
laparoscopic inguinal hernia repair. Rev man software was used to analyze the
data according to random effects models.Results:
Six studies, of 3246 patients were included, 1025 patients
underwent robot-assisted and 2221patients underwent laparoscopic surgery. The
review showed that robotic-assisted inguinal hernia may reduce the pain
compared with laparoscopic, while hospitals cost was significantly higher in
robotic surgery than laparoscopic. There was no significant difference between
robotic and laparoscopic surgery in decreasing surgical site infection
(OR=4.08, 95%CI: 0.39-43.02, P=0.24), hospital length (MD=0.03, 95%CI:
0.04-0.10, P=0.34), the incidence of hematoma (OR=1.38, 95%CI: 0.57-3.37,
P=0.48), seroma (OR=1.15, 95%CI: 0.61-2.15, P=0.67), urinary retention
(OR=1.42, 95%CI: 0.67-2.97, P=0.36), and complication (OR=1.158,
95%CI:0.87-2.87, P=0.14).Conclusions:
This study showed robotic-assisted
inguinal hernia might reduce pain compared with the laparoscopic group but
incurred higher costs. There was no significant difference between robotic and
laparoscopic surgery in other efficacy and safety outcomes, which im plying
that robotic surgery could be an alternative procedure to laparoscopic instead
of replacement in inguinal hernia repair. More robust and high-value randomized
trials are required to determine the safety and efficacy of robot-assisted
inguinal hernia repair.
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