The outcomes of robotic ileocolic resection in Crohn’s disease compared with laparoscopic and open surgery: a meta-analysis and systematic review

Abstract

BACKGROUND: This is the first review providing insights into the outcomes of robotic ileocolic resection for Crohn's disease, potentially guiding improved surgical decisions and patient outcomes and comparing outcomes with laparoscopic and open approaches. METHODS: The review was registered prospectively with PROSPERO (CRD42024504839). A comprehensive search of MEDLINE, Embase, Scopus, and Cochrane Central databases for studies on robotic ileocolic resection for Crohn's disease from inception to February 2024 was conducted. Eligible studies included participants over 18 years of age with Crohn's disease undergoing robotic ileocolic resection. Data were extracted according to PRISMA guidelines. For single-arm analyses, the random-effects model was used, while two-arm analyses employed the inverse variance and Mantel-Haenszel methods. RESULTS: The analysis included eight studies with 5760 patients, among whom 369 underwent robotic ileocolic resection. The mean operative time for robotic procedures was 226 min. Postoperative complications included ileus in 12.50% and wound complications in 7.00%, while reoperations and readmissions occurred in 3.60% and 13.20% of patients, respectively. When compared with laparoscopic procedures, robotic procedures showed shorter length of hospital stay and longer operative times but similar total complication, reoperation, and conversion rates. In contrast, robotic procedures had fewer total postoperative complications compared with open surgeries, despite longer operative times. CONCLUSIONS: Robotic ileocolic resection for Crohn's disease, while having a longer operative time, results in fewer postoperative complications compared with open surgery and shows comparable outcomes to laparoscopic procedures with shorter hospital stays.