Surgical Department, Hamad Medical Corporation, Doha, Qatar.
School of Medicine, Dentistry and Nursing, The University of Glasgow, Glasgow, UK.
ANZ J Surg. 2021 Nov;91(11):2277-2287. doi: 10.1111/ans.16505. Epub 2021 Jan 21.
We aimed to conduct a systematic review and meta-analysis of RHR's efficiency and safety, in addition to comparison between open and laparoscopic techniques.
A literature review was conducted from 2000 to 2020 including studies reporting on their centre's outcomes for robotic hernial repairs. A meta-analysis was conducted. For continuous data, Mantel-Haenszel chi-squares test was used and inverse variance was used for dichotomous data.
In total, 19 studies were included. A total of 8987 patients were treated for hernia repairs, 4248 underwent open repairs, 2521 had robotic repairs and 1495 had laparoscopic repair. Cumulative analysis of robotic series: The overall average operative time was 90.8 min (range 25-180.7 min). The overall conversation rate was 0.63% (10/1596). The overall complication rate was 10.1% (248/2466). The overall recurrence rate was 1.2% (14/1218). Readmission rate was 1.6% (28/1750). Comparative meta-analysis outcomes include robotic versus open and robotic versus laparoscopic. Robotic versus open: The robotic group had significantly longer operative times and less readmission rates. There was no difference between the two groups regarding complications, post-operative pain occurrence and hernia recurrence rates. Robotic versus laparoscopic: The robotic group had significantly longer operative times and less complications. There was no difference regarding post-operative pain occurrence, hernia recurrence rates or readmission rates.
Robotic hernia repair is a safe and efficient technique with minimal complications and a short learning curve; however, it remains inferior to the standard open technique. It does, however, have a role in minimally invasive technique centres. A multicentre randomized control trial is required comparing robotic, open and laparoscopic techniques.
本研究旨在对机器人疝修补术的效率和安全性进行系统评价和荟萃分析，并比较开放和腹腔镜技术。
从 2000 年至 2020 年进行文献回顾，纳入报道机器人疝修补术中心结果的研究。进行荟萃分析。对于连续数据，使用 Mantel-Haenszel 卡方检验，对于二分类数据，使用逆方差。
共纳入 19 项研究，共 8987 例患者接受疝修补术治疗，其中 4248 例接受开放修补术，2521 例接受机器人修补术，1495 例接受腹腔镜修补术。机器人系列的累积分析：总的平均手术时间为 90.8 分钟（范围 25-180.7 分钟）。总的转化率为 0.63%（10/1596）。总的并发症发生率为 10.1%（248/2466）。总的复发率为 1.2%（14/1218）。再入院率为 1.6%（28/1750）。比较荟萃分析结果包括机器人与开放手术和机器人与腹腔镜手术。机器人与开放手术：机器人组手术时间明显较长，再入院率较低。两组在并发症、术后疼痛发生和疝复发率方面无差异。机器人与腹腔镜手术：机器人组手术时间明显较长，并发症较少。两组在术后疼痛发生、疝复发率或再入院率方面无差异。
机器人疝修补术是一种安全有效的技术，并发症少，学习曲线短；但仍逊于标准开放技术。然而，它在微创技术中心有一定的作用。需要进行一项多中心随机对照试验，比较机器人、开放和腹腔镜技术。
