Background
Methods
Inclusion criteria
Exclusion criteria
Data extraction
Primary outcomes
Secondary outcomes
Results
Study* | Years of the study | City Nation | Type of trial | N. of patients | Author’s definition of Robotic treatment | Type of treatment | Type of technique |
---|---|---|---|---|---|---|---|
Abdalla [15] 2012 | 2008-2011 | São Paulo, Brasil | Case series | 27 | Robotic assisted gastric band placements | 6 Gastric band placements, 5 Vertical gastrectomies and 16 Gastric by-pass in Roux-en-Y | NR1
|
Robotic assisted vertical gastrectomies | |||||||
Robotic asssisted gastric by-pass in Roux-en-Y | |||||||
Buchs [16] 2012 | 2006-2010 | Geneva, Switzerland | Case series | 167 | Robotic-assisted Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Hagen [7] 2012 | 1997-2010 | Geneva, Switzerland | CCT | 143 | Robotic-assisted Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Tieu [17] 2012 | 2002-2010 | Houston, USA | Case series | 1100 | Robotic-assisted Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Vilallonga [18] 2012 | 2010-2011 | Barcelona, Spain | Case series | 32 | Robot-Assisted Sleeve Gastrectomy | Sleeve Gastrectomy | Fully Robotic |
Ayloo [19] 2011 | 2007 - 2010 | Chicago, USA | CCT | 30 | Robot-Assisted Sleeve Gastrectomy | Sleeve Gastrectomy | Fully Robotic |
Diamantis [20] 2011 | 2008-2009 | Athens, Greece | CCT | 19 | Robotic Sleeve Gastrectomy | Sleeve Gastrectomy | Fully Robotic |
Edelson [21] 2011 | 2006-2009 | Philadelphia, USA | CCT | 287 | Robotic gastric banding | Gastric banding | Fully Robotic |
Park [22] 2011 | 2007-2009 | Honolulu, USA | CCT | 105 | Robotic-assisted Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | NR |
Scozzari [8] 2011 | 2006-2009 | Torino, Italy | CCT | 110 | Robotic-assisted Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Fully Robotic |
Curet [23] 2009 | 2005 | Stanford, USA | CCT | 21 | Robotic Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Fully Robotic |
Deng [24] 2008 | 2006-2007 | Pasadena, USA | Case series | 100 | Robotic-assisted Laparoscopic Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Fully Robotic |
Hubens [25] 2008 | 2004-2006 | Antwerpen, The Netherlands | CCT | 45 | Robotic Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Fully Robotic |
Sudan [26] 2007 | NR | Omaha, USA | Case series | 47 | Robotically assisted biliopancreatic diversion with duodenal switch | Biliopancreatic diversion with duodenal switch | Laparoscopic-Robotic |
Parini [27] 2006 | 2000-2004 | Aosta, Italy | Case series | 17 | Laparoscopic gastric bypass performed with the Da Vinci Intuitive Robotic System | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Mohr [28] 2006 | 2004-2005 | Stanford, USA | Case series | 75 | Totally Robotic Laparoscopic Roux-en-Y Gastric Bypass | Roux-en-Y gastric bypass | Fully Robotic |
Yu [29] 2006 | 2003-2005 | Houston, USA | Case series | 100 | Robotic assistance for laparoscopic Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Ali [30] 2005 | 2002-2003 | Sacramento, USA | Case series | 50 | Robot-assisted laparoscopic Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Artuso [31] 2005 | 2001-2002 | New York, USA | Case series | 41 | Laparoscopic gastric bypass performed with robotics | Roux-en-Y gastric bypass | Laparoscopic-Robotic |
Galvani [32] 2005 | 2000-2004 | Chicago, USA | Case series | 140 | Robot-assisted surgery | 110 Gastric bypass procedures 30 Lap band | Laparoscopic-Robotic |
Sanchez [33] 2005 | 2004-2005 | Stanford, USA | RCT | 25 | Totally robotic laparoscopic Roux-en-Y gastric bypass | Roux-en-Y gastric bypass | Fully Robotic |
Muhlmann [34] 2003 | NR | Innsbruck, Austria | CCT | 10 | Robotic-assisted laparoscopic silicone adjustable gastric banding Robotic implantable gastric stimulator | 4 silicone adjustable gastric banding | Laparoscopic-Robotic |
2 implantable gastric stimulator | |||||||
4 silicone adjustable gastric banding reoperation |
Study* | Mean preoperative age (years) | Mean weight [kg] | Mean Body Mass Index [kg/m2] |
---|---|---|---|
Abdalla [15] | NR1
| NR | NR |
Buchs [16] | 43 | 122.8 | 44 |
Hagen [7] | 42.6 | NR | 44.5 |
Tieu [17] | 46.9 | 131.9 | 47.9 |
Vilallonga [18] | 44.7 | NR | 48.3 |
Ayloo [19] | 38 | 152 | 57 |
Diamantis [20] | 39.4 | NR | 48.2 |
Edelson [21] | 45 | NR | 45.4 |
Park [22] | 42.2 | NR | 46.77 |
Scozzari [8] | 42.6 | 127.5 | 46.7 |
Curet [23] | 46.5 | NR | 45.6 |
Deng [24] | 41.7 | NR | 48 |
Hubens [25] | 42 | NR | 44.2 |
Sudan [26] | 38 | NR | 45 |
Parini [27] | 42.9 | NR | 50.3 |
Mohr [28] | 44 | NR | 46.1 |
Yu [29] | 42 | NR | 50 |
Ali [30] | 42 | NR | 47 |
Artuso [31] | 42.5 | 146.2 | 52.8 |
Galvani [32] | NR | NR | NR |
Sanchez [33] | 43.3 | NR | 45.5 |
Muhlmann [34] | NR | NR | 41.5 |
Items/author* | [[7]] | [[19]] | [[20]] | [[21]] | [[22]] | [[8]] | [[23]] | [[25]] | [[33]] | [[34]] |
---|---|---|---|---|---|---|---|---|---|---|
Inclusion criteria | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 0 |
Exclusion criteria | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Comparable demographics? | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Could the number of participating centres be determined? | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Could the number of surgeons who participated be determined? | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 1 |
Could the reader determine where the authors were on the learning curve for the reported procedure? | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 0 |
Were diagnostic criteria clearly stated for clinical outcomes if required? | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Was the surgical technique adequately described? | 1 | 1 | 1 | 0 | 0 | 1 | 0 | 1 | 0 | 1 |
Did they try to standardize the surgical technique? | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 0 | 1 |
Did they try to standardize perioperative care? | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Was the age and range given for patients in the Robotic group? | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 |
Did the authors address whether there were any missing data? | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 0 |
Was the age and range given for patients in the comparative group? | 1 | 0 | 0 | 1 | 1 | 1 | 0 | 1 | 1 | 1 |
Were patients in each group treated along similar timelines? | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
The patients asking to enter the study, did they actually take part to it? | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
Were drop-out rates stated? | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
Were outcomes clearly defined? | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Were there blind assessors? | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Were there standardized assessment tools? | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
Was the analysis by intention to treat? | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
Score | 12 | 9 | 10 | 9 | 10 | 10 | 7 | 12 | 15 | 9 |
Items/author* | [[15]] | [[16]] | [[17]] | [[18]] | [[24]] | [[26]] | [[27]] | [[28]] | [[29]] | [[30]] | [[31]] | [[32]] |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Case series collected in more than one centre, i.e. multi-centre study | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Is the hypothesis/aim/objective of the study clearly described?
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Are the inclusion andexclusion criteria (case definition) clearly reported?
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 |
Is there a clear definition of the outcomes reported?
| 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
Were data collected prospectively? | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 |
Is there an explicit statement that patients were recruited consecutively?
| 0 | 0 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 0 | 0 |
Are the main findings of the study clearly described?
| 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
Are outcomes stratified? (e.g., by disease stage, abnormal test results, patient characteristics)
| 0 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 |
Total Score
| 3 | 5 | 7 | 6 | 6 | 4 | 6 | 5 | 7 | 5 | 4 | 1 |
Primary outcomes
Study | Intraoperative conversions | 30-day reoperations | 30-day postoperative mortality | Mean body mass index 3 months after surgery |
---|---|---|---|---|
Abdalla [15] | 0 | 1 | 0 | NR1
|
Buchs [16] | 2 | 2 | 0 | NR |
Hagen [7] | 2 | 1 | 0 | 44.5 |
Tieu [17] | 0 | NR | 0 | 39.8 |
Vilallonga [18] | 0 | 0 | 0 | NR |
Ayloo [19] | 0 | 1 | 0 | NR |
Diamantis [20] | 0 | 0 | 0 | reduced of 31.3% |
Edelson* [21] | 0 | 11 | 0 | NR |
Park [22] | 1 | 1 | 0 | NR |
Scozzari [8] | 0 | 2 | 0 | reduced of 33.6% |
Curet [23] | NR | NR | 0 | NR |
Deng [24] | NR | 0 | 0 | 17.5% |
Hubens [25] | 9 | 2 | 0 | NR |
Sudan [26] | 3 | NR | 0 | NR |
Parini [27] | 0 | 0 | 0 | 39.07 |
Mohr [28] | 4 | NR | 0 | reduced of 48% |
Yu [29] | 0 | 2 | 0 | NR |
Ali [30] | NR | NR | NR | NR |
Artuso [31] | NR | NR | NR | NR |
Galvani [32] | NR | NR | NR | NR |
Sanchez [33] | 1 | NR | NR | NR |
Muhlman [34] | NR | NR | 0 | NR |
Secondary outcomes
Study* | 30-day major complications | 30-day minor complications | Pulmonary embolism | Deep venous thrombosis | Readmissions in the first 30 postoperative days |
---|---|---|---|---|---|
Abdalla [15] | 1 | 5 | 0 | 0 | NR1
|
Buchs [16] | 24 (not classified) | 7 | 2 | 2 | |
Hagen [7] | 23 (not classified) | NR | NR | NR | |
Tieu [17] | 45 | 102 | 2 | 3 | 67 |
Vilallonga [18] | 1 case | NR | NR | NR | NR |
Ayloo [19] | NR | NR | NR | 0 | |
Diamantis [20] | 0 (not classified) | 0 | 0 | 0 | |
Edelson [21] | NR | NR | NR | NR | |
Park [22] | 10 (not classified) | 0 | 0 | 0 | |
Scozzari [8] | 4 | 14 | 1 | NR | NR |
Curet [23] | 3 (not classified) | NR | NR | NR | |
Deng [24] | 4 | 7 | NR | NR | 3 |
Hubens [25] | NR | NR | NR | NR | NR |
Sudan [26] | NR | NR | NR | NR | NR |
Parini [27] | 0 | 0 | 0 | 0 | 0 |
Mohr [28] | 6 | 7 | NR | NR | NR |
Yu [29] | NR | NR | 1 | NR | NR |
Ali [30] | NR | NR | NR | NR | NR |
Artuso [31] | NR | NR | NR | NR | NR |
Galvani [32] | NR | NR | NR | NR | NR |
Sanchez [33] | NR | NR | NR | NR | NR |
Muhlmann [34] | NR | NR | NR | NR | NR |
Study* | Post-operative anastomotic leak | Anastomotic stricture Gastro-jejunostomy | Anastomotic bleeding | Post-operative bowel obstruction | |
---|---|---|---|---|---|
g-j | j-j | ||||
Abdalla [15] | 0 | 0 | 0 | 0 | 0 |
Buchs [16] | 0 | 0 | 3 | NR3
| 1 |
Hagen [7] | 0 | 0 | 0 | 3 | NR |
Tieu [17] | 1 | 1 | 7 | 9 | 19 |
Park [22] | 2 | 0 | 2 | 0 | 0 |
Scozzari [8] | 2 | 0 | 3 | 0 | 1 |
Curet [23] | 0 | 0 | 0 | 0 | 0 |
Deng [24] | 1 | 0 | 4 | 3 | 0 |
Hubens [25] | 0 | 0 | 2 | 0 | 1 |
Parini [27] | 0 | 0 | 0 | 0 | 0 |
Mohr [28] | 0 | 0 | 2 | 0 | 0 |
Yu [29] | 0 | 0 | 2 | 0 | 0 |
Ali [30] | NR | NR | NR | NR | NR |
Artuso [31] | 1 | 0 | 0 | 0 | 0 |
Galvani [32] | NR | NR | NR | NR | NR |
Sanchez [33] | NR | NR | NR | NR | NR |
Surgical treatment | Study | Suture leak | Suture stricture | Suture bleeding | Bowel obstruction/internal hernia |
---|---|---|---|---|---|
Sleeve gastrectomy | Vilallonga [18] | 0 | 0 | 0 | 0 |
Ayloo [19] | 0 | 1 | 0 | 0 | |
Diamantis [20] | 0 | 0 | 0 | 0 | |
Duodenal switch | Sudan [26] | 4 | 0 | 0 | 0 |
Study* | Mean operative time (min.) | Length of hospital stay Mean ± Standard deviation (days) |
---|---|---|
Abdalla [15] | NR1
| NR |
Buchs [16] | 295.2 | 7.2 ± 2.5 |
Hagen [7] | 293 | 7.4 ± 2.6 |
Tieu [17] | 155 | NR |
Vilallonga [18] | 130.2 | NR |
Ayloo [19] | 135 | 2.6 |
Diamantis [20] | 95.5 | 4 |
Edelson [21] | 91.5 | 1.3 |
Park [22] | 169 | 3.41 ± 7.03 |
Scozzari [8] | 247.5 | 7.8 |
Curet [23] | 181.7 | 3 |
Deng [24] | 186.3 | 1.5 |
Hubens [25] | 242.2 | 4.7 |
Sudan [26] | 514 | NR |
Parini [27] | 201 | 9 |
Mohr [28] | 140 | 2.9 |
Yu [29] | 254 | NR |
Ali [30] | NR | NR |
Artuso [31] | 289 | 4.6 |
Galvani [32] | NR | NR |
Sanchez [33] | 130.8 | 2.72 |
Muhlman [34] | 137 | 3 |