New Robotic Platforms in General Surgery: What's the Current Clinical Scenario?

Journal: Medicina (Kaunas, Lithuania)
Published Date:

Abstract

: Robotic surgery has been widely adopted in general surgery worldwide but access to this technology is still limited to a few hospitals. With the recent introduction of new robotic platforms, several studies reported the feasibility of different surgical procedures. The aim of this systematic review is to highlight the current clinical practice with the new robotic platforms in general surgery. : A grey literature search was performed on the Internet to identify the available robotic systems. A PRISMA compliant systematic review was conducted for all English articles up to 10 February 2023 searching the following databases: MEDLINE, EMBASE, and Cochrane Library. Clinical outcomes, training process, operating surgeon background, cost-analysis, and specific registries were evaluated. : A total of 103 studies were included for qualitative synthesis after the full-text screening. Of the fifteen robotic platforms identified, only seven were adopted in a clinical environment. Out of 4053 patients, 2819 were operated on with a new robotic device. Hepatopancreatobiliary surgery specialty performed the majority of procedures, and the most performed procedure was cholecystectomy. Globally, 109 emergency surgeries were reported. Concerning the training process, only 45 papers reported the background of the operating surgeon, and only 28 papers described the training process on the surgical platform. Only one cost-analysis compared a new robot to the existing reference. Two manufacturers promoted a specific registry to collect clinical outcomes. : This systematic review highlights the feasibility of most surgical procedures in general surgery using the new robotic platforms. Adoption of these new devices in general surgery is constantly growing with the extension of regulatory approvals. Standardization of the training process and the assessment of skills' transferability is still lacking. Further studies are required to better understand the real clinical and economical benefit.

Authors

  • Francesco Marchegiani
    First Surgical Clinic, Department of Surgical Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
  • Leandro Siragusa
    Department of Surgical Sciences, University of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy.
  • Alizée Zadoroznyj
    Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France.
  • Vito Laterza
    Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France.
  • Orsalia Mangana
    Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France.
  • Carlo Alberto Schena
    Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France.
  • Michele Ammendola
    Science of Health Department, Digestive Surgery Unit, University "Magna Graecia" Medical School, 88100 Catanzaro, Italy.
  • Riccardo Memeo
  • Paolo Pietro Bianchi
    Department of General and Minimally-invasive Surgery, International School of Robotic Surgery, Misericordia Hospital, Grosseto, Italy.
  • Giuseppe Spinoglio
    Program of Hepatobiliary, Pancreatic and Colorectal Surgery, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov.le 142, km. 3,95, 10060, Candiolo, TO, Italy.
  • Paschalis Gavriilidis
    Department of HBP Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, UK.
  • Nicola de'Angelis
    Unit of Digestive, Hepatobiliary, and Pancreatic Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), Créteil, France. nic.deangelis@yahoo.it.