Efficacy and safety of robot-assisted versus endo-laparoscopic ventral hernia repair: a meta-analysis of randomized controlled trials

Abstract

PURPOSE: To comprehensively compare the surgical outcomes of robotic ventral hernia repair (rVHR) with traditional endo-laparoscopic ventral hernia repair (lapVHR) using systematic review methods, evaluating the efficacy and safety of rVHR and providing reference for clinical applications of rVHR. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) list. The following electronic databases were searched: PubMed, Web of science, Cochrane library, Embase, Scopus, and SpringerLink. The retrieval period spanned from the inception of database until 2024. Only randomized controlled trials were included. Outcomes of recurrence, re-hernioplasty, operative time, length of hospital stay and surgical site occurrence were compared between rVHR and lapVHR. RESULTS: A total of 5 studies (237 patients) were included in the meta-analysis. Compared with lapVHR, the treatment of rVHR significantly decreased re-hernioplasty (RR = 0.17, 95% CI 0.04-0.66). Additionally, rVHR significantly reduced the length of hospital stay (MD = 0.48, 95% CI: 0.25, 0.71) and operative time (MD = 69.45, 95%CI: 45.76, 93.14). In addition, rVHR can reduce the recurrence rate, but it is a marginal statistical difference (RR = 0.46, 95% CI: 0.19, 1.13). CONCLUSION: Overall, both rVHR and lapVHR were effective and safe. Nevertheless, rVHR shows superiority in terms of recurrence rate and re-hernioplasty rate. More high-quality studies are warranted to validate the results of this study.