Robot-assisted Procedures in General Surgery: Cholecystectomy, Inguinal and Ventral Hernia Repairs

摘要

General surgery procedures make up a large volume of operations performed in the US. For example there are approximately 1 million cholecystectomies and 800,000 ventral and inguinal hernia cases performed each year. Within this field we are experiencing dramatic recent growth in the number of robot-assisted cases. Questions about the utility of robot-assisted surgery as compared to laparoscopic and open surgery persist. In particular, does the use of the robot translate to better or similar clinical outcomes for patients? Are operating room times and length of stay comparable or improved with use of robot versus laparoscopic or open techniques? And what are costs of robot-assisted surgery and are they justified? Yet there is no consensus or guidelines on when to use which surgical approach and decisions are left up to individual practitioners or hospital leadership. To help clinicians, patients, and policymakers better assess the appropriateness of robot-assisted compared to other surgical approaches, we were asked to conduct a systematic review of the literature on 3 of the most common general surgery operations: cholecystectomy, inguinal hernia repair, and incisional hernia repair.