Lai, Tzu-Jung and Roxburgh, Campbell and Boyd, Kathleen Anne and Bouttell, Janet (2024) Clinical effectiveness of robotic versus laparoscopic and open surgery: an overview of systematic reviews. BMJ Open, 14 (9): e076750. ISSN 2044-6055
AI Summary:
The review of systematic reviews on robotic-assisted surgery found that for most clinical outcomes, the evidence was largely positive or neutral for robotic-assisted surgery compared to open and laparoscopic alternatives. However, the evidence for operative time was mostly negative.AI Topics:
Objective: To undertake a review of systematic reviews on the clinical outcomes of robotic-assisted surgery across a mix of intracavity procedures, using evidence mapping to inform the decision makers on the best utilisation of robotic-assisted surgery.
Eligibility criteria: We included systematic reviews with randomised controlled trials and non-randomised controlled trials describing any clinical outcomes.
Data sources: Ovid Medline, Embase and Cochrane Library from 2017 to 2023.
Data extraction and synthesis: We first presented the number of systematic reviews distributed in different specialties. We then mapped the body of evidence across selected procedures and synthesised major findings of clinical outcomes. We used a measurement tool to assess systematic reviews to evaluate the quality of systematic reviews. The overlap of primary studies was managed by the corrected covered area method.
Results: Our search identified 165 systematic reviews published addressing clinical evidence of robotic-assisted surgery. We found that for all outcomes except operative time, the evidence was largely positive or neutral for robotic-assisted surgery versus both open and laparoscopic alternatives. Evidence was more positive versus open. The evidence for the operative time was mostly negative. We found that most systematic reviews were of low quality due to a failure to deal with the inherent bias in observational evidence.
Conclusion: Robotic surgery has a strong clinical effectiveness evidence base to support the expanded use of robotic-assisted surgery in six common intracavity procedures, which may provide an opportunity to increase the proportion of minimally invasive surgeries. Given the high incremental cost of robotic-assisted surgery and longer operative time, future economic studies are required to determine the optimal use of robotic-assisted surgery capacity.
Lai, Tzu-Jung
Author
Lai, Tzu-Jung and Roxburgh, Campbell and Boyd, Kathleen Anne and Bouttell, Janet (2024) Clinical effectiveness of robotic versus laparoscopic and open surgery: an overview of systematic reviews. BMJ Open, 14 (9): e076750. ISSN 2044-6055
See full publications listRoxburgh, Campbell S. D.
Author
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See full publications listBoyd, Kathleen
Author
Lai, Tzu-Jung and Roxburgh, Campbell and Boyd, Kathleen Anne and Bouttell, Janet (2024) Clinical effectiveness of robotic versus laparoscopic and open surgery: an overview of systematic reviews. BMJ Open, 14 (9): e076750. ISSN 2044-6055
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See full publications listBouttell, Janet
Author
Lai, Tzu-Jung and Roxburgh, Campbell and Boyd, Kathleen Anne and Bouttell, Janet (2024) Clinical effectiveness of robotic versus laparoscopic and open surgery: an overview of systematic reviews. BMJ Open, 14 (9): e076750. ISSN 2044-6055
Bouttell, Janet and Fraser, Heather and Goodlad, John R. and Hopkins, David and McKay, Pam and Oien, Karin A. and Seligmann, Bruce and Von Delft, Stephan and Hawkins, Neil (2024) Adding a gene expression profile test to aid differential diagnosis and treatment in aggressive large B-cell lymphoma: an early exploratory economic evaluation. Applied Health Economics and Health Policy, 22 (2). pp. 243-254. ISSN 1175-5652
See full publications listAvailable under License Creative Commons Attribution Non-commercial.
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