Robot-assisted surgery in thoracic and visceral indications – Update 2023

Riegelnegg M, Gassner L, Grössmann-Waniek N
Record ID 32018004981
Authors' objectives: Robot-assisted surgery is a minimally invasive procedure where instruments are controlled through a telemanipulator. This is intended to lead to higher dexterity compared to the human hand and the laparoscope, thus allowing for a higher level of precision. Robot-assisted procedures claim to enhance clinical outcomes and reduce healthcare resource utilisation when compared to open surgery or laparoscopy. The present report is an update of a systematic review from 2019, which investigated the effectiveness and safety of robot-assisted surgery compared to open surgery and conventional laparoscopy in thoracic and visceral indications.
Authors' results and conclusions: For five out of the 14 procedures, no evidence could be identified. In total, 20 randomised controlled trials and five follow-up publications met the inclusion criteria. In most studies, relevant endpoints were either not reported, not measured, or did not show statistically significant differences. Regarding some endpoints (e.g. blood loss), robot-assisted procedures showed advantages, but these results were only shown by a few studies with low-quality evidence. As for the operation time, only conflicting results could be identified. In general, robot-assisted surgery is associated with higher costs in terms of acquisition and maintenance compared to conventional procedures. Additionally, it is associated with an increased environmental impact due to higher greenhouse gas emissions and waste generation. In conclusion, due to the heterogeneous results and the lack of evidence for a variety of study endpoints, a general statement about the effectiveness and safety of robot-assisted surgery is not possible. Furthermore, most of the extracted results did not support the claimed benefits of robot-assisted procedures.
Project Status: Completed
Year Published: 2023
URL for additional information:
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Robotic Surgical Procedures
  • Surgical Procedures, Operative
  • Minimally Invasive Surgical Procedures
  • Thoracic Surgical Procedures
  • Gastrointestinal Tract
  • Thoracic Duct
  • Bariatric Surgery
  • Cholecystectomy, Laparoscopic
  • Herniorrhaphy
  • Robotic surgery
  • robot-assisted surgery
  • da Vinci
  • thoracic surgery
  • visceral surgery
  • laparoscopy
  • open surgery
Organisation Name: Austrian Institute for Health Technology Assessment
Contact Address: Garnisongasse 7/20, A-1090 Vienna, Austria
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This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.