Comparison of emerging Chinese robot-assisted surgery systems and the da Vinci surgical system: A meta-analysis and systematic review

摘要

To synthesize and compare the intraoperative performance of the emerging Chinese surgical robot (CNR) and its postoperative impacts on patients with the Da Vinci surgical robot (DVR). A search of articles published before April 2024 was launched in Embase, Scopus, PubMed, Web of Science, and Cochrane Center for meta-analysis and systematic review. Intraoperative and postoperative outcomes were evaluated between CNRs and DVRs. The meta-analysis results, performed using Review Manager (RevMan) (Version 5.4), were reported as risk ratios (RR) for binary variables via the Mantel-Haenszel method and as mean difference (MD) for continuous variables via the inverse variance method. All effect estimates were accompanied by a 95 % confidence interval (CI) and statistical significance was established with a two-tailed p-value of less than 0.05 (p < 0.05). Eight studies, 541 individuals totally, were incorporated into the analysis. CNRs had a longer operating time than DVRs [MD 9.44, 95 %CI 3.33, 15.56, p = 0.002]. However, the conversion rate, intraoperative blood loss, postoperative hospital stay, complication rate, number of lymph nodes retrieved and robotic docking time failed to show noticeable differences. Subgroup analysis revealed Kangduo surgical robots took more operating time than Da Vinci robots [MD 15.37, 95 %CI 8.98, 21.76, p < 0.00001]. Despite the extended operating time associated with CNRs, the surgical outcomes showed no significant differences. Hence, we can assert CNRs are not inferior to DVRs in terms of intraoperative performance and postoperative patient recovery. • This is the first meta-analysis comparing the surgical outcomes of mainstream emerging CNRs with the DVR, summarizing 8 studies involving a total of 541 patients. • Compared to the DVR, CNRs cost longer operating time. Further subgroup analysis revealed variations in operating time among different Chinese robots. • The emerging CNRs are not inferior to the DVR in terms of intraoperative performance and postoperative patient recovery.