Abstract:

BACKGROUND: Compared with conventional laparoscopic techniques, robot-assisted surgery, especially the Da Vinci Surgical System, can provide a good three-dimensional imaging, better human bioengineering design and more sophisticated operations.
OBJECTIVE: To evaluate the efficacy and feasibility of robotic Nissen fundoplication for the treatment of gastroesophageal reflux disease through Meta-analysis.
METHODS: A comprehensive search of PubMed database, Embase database and OVID database was performed by computer to determine all published research papers on the comparison of robotic versus conventional laparoscopic Nissen fundoplication for the treatment of gastroesophageal reflux disease. The inverse-variance method and Mantel-Haenszel method were used for the analysis depending on the data type with fixed effect model or random effect model according to the heterogeneity.
RESULTS AND CONCLUSION: Five studies met the criteria finally, which included 160 patients. Meta analysis showed that except the intraoperative and postoperative complications, statistical differences were not observed in the other outcomes between conventional laparoscopic group and robotic Nissen fundoplication group, including total operating interval, effective operating interval, postoperative dysphagia, conversions, re-operation rate, hospital stay and in-hospital costs (P > 0.05). It indicates that the robotic Nissen fundoplication is not superior to the traditional laparoscopic surgery in the treatment of gastroesophageal reflux disease. Therefore, we should select the indications carefully.