Robotic-Assisted Surgery Using the Da Vinci Surgical System in a Nordic Population: A Systematic Literature Review and Meta-Analysis
Author(s)
Ana Yankovsky, MSc1, Usha Kreaden, MSc1, Neera Patel, MS1, April E. Hebert, PhD1, James Lavin, MS2.
1Intuitive Surgical, Sunnyvale, CA, USA, 2Intuitive Surgical, Aubonne, Switzerland.
1Intuitive Surgical, Sunnyvale, CA, USA, 2Intuitive Surgical, Aubonne, Switzerland.
OBJECTIVES: To compare the perioperative outcomes of da Vinci robotic-assisted surgery (dV-RAS) with laparoscopic (LAP) or open surgery for 7 malignant procedures in patients from Nordic countries.
METHODS: PubMed, Scopus and EMBASE were systematically searched from 2010 to December 31, 2022 following PRISMA guidelines (PROSPERO#CRD42023466759). Studies published on Nordic patients undergoing radical prostatectomy, partial nephrectomy, hysterectomy, lobectomy, right colectomy, or rectal resection for cancer were included. Data were pooled as odds ratios (OR) or mean differences (MD) in R using fixed-effect or random-effects (heterogeneity significant). Bias was assessed using ROBINS-I/RoB 2 tools.
RESULTS: Sixteen studies (3 randomized, 6 prospective, 7 database) satisfied eligibility criteria, including 8975 dV-RAS, 6568 LAP, and 5525 open patients. Nine studies were from Sweden, four from Denmark, two from Norway and one from Finland. Compared to LAP, dV-RAS patients were less likely to undergo a conversion (OR=0.38[0.19,0.75],p<0.01), had lower estimated blood loss (MD=-14.47[-23.14,-5.81] and had a shorter hospital stay (MD=-0.61[-1.12,-0.11],p=0.02). The dV-RAS group had similar operative times and similar blood transfusion, postoperative complication, reoperation, and short-term mortality rates as LAP. No data was available for reoperations for dV-RAS versus LAP. When compared to open surgery, dV-RAS patients had lower estimated blood loss (MD=-299.96[-415.95,-183.98],p<0.01) fewer blood transfusions (OR=0.15[0.11,0.21],p<0.01), and a shorter length of stay (MD=-2.09[-3.22,-0.95],p<0.01). The dV-RAS group had similar operative time, postoperative complications, reoperation, readmission and short-term mortality rates versus the open approach.
CONCLUSIONS: Available evidence for Nordic population concludes that dV-RAS is better or equivalent to LAP or open for select perioperative outcomes for 7 malignant procedures. Additional research is needed for reoperation and readmission rates. However, these findings could inform researchers, payers, policy makers and Health Technology Agencies in their decision-making processes.
METHODS: PubMed, Scopus and EMBASE were systematically searched from 2010 to December 31, 2022 following PRISMA guidelines (PROSPERO#CRD42023466759). Studies published on Nordic patients undergoing radical prostatectomy, partial nephrectomy, hysterectomy, lobectomy, right colectomy, or rectal resection for cancer were included. Data were pooled as odds ratios (OR) or mean differences (MD) in R using fixed-effect or random-effects (heterogeneity significant). Bias was assessed using ROBINS-I/RoB 2 tools.
RESULTS: Sixteen studies (3 randomized, 6 prospective, 7 database) satisfied eligibility criteria, including 8975 dV-RAS, 6568 LAP, and 5525 open patients. Nine studies were from Sweden, four from Denmark, two from Norway and one from Finland. Compared to LAP, dV-RAS patients were less likely to undergo a conversion (OR=0.38[0.19,0.75],p<0.01), had lower estimated blood loss (MD=-14.47[-23.14,-5.81] and had a shorter hospital stay (MD=-0.61[-1.12,-0.11],p=0.02). The dV-RAS group had similar operative times and similar blood transfusion, postoperative complication, reoperation, and short-term mortality rates as LAP. No data was available for reoperations for dV-RAS versus LAP. When compared to open surgery, dV-RAS patients had lower estimated blood loss (MD=-299.96[-415.95,-183.98],p<0.01) fewer blood transfusions (OR=0.15[0.11,0.21],p<0.01), and a shorter length of stay (MD=-2.09[-3.22,-0.95],p<0.01). The dV-RAS group had similar operative time, postoperative complications, reoperation, readmission and short-term mortality rates versus the open approach.
CONCLUSIONS: Available evidence for Nordic population concludes that dV-RAS is better or equivalent to LAP or open for select perioperative outcomes for 7 malignant procedures. Additional research is needed for reoperation and readmission rates. However, these findings could inform researchers, payers, policy makers and Health Technology Agencies in their decision-making processes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO214
Topic
Clinical Outcomes, Medical Technologies, Methodological & Statistical Research
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Oncology