Skip to main content
SpringerLink
Log in

Robotic versus laparoscopic surgery for gastric cancer: an overview of systematic reviews with quality assessment of current evidence

  • Review Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Many systematic reviews have been published to evaluate the clinical benefits of robotic surgery for gastric cancer. However, these reviews have investigated various outcomes and differ considerably in quality. In this overview, we summarize the findings and quality of these reviews. A comprehensive literature search was conducted using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials to identify systematic reviews and meta-analyses that compared robotic surgery with laparoscopic surgery for gastric cancer. We summarized the results of the meta-analyses and evaluated the quality of the reviews using the AMSTAR-2 tool. The literature search identified 14 eligible reviews. The reviews showed that estimated blood loss was significantly less and time to resumption of oral intake was significantly shorter in patients who underwent robotic surgery than in those who underwent laparoscopic surgery. However, no significant differences in other outcomes were found between the two types of surgery. The quality of the included reviews was judged to be critically low. In conclusion, the available evidence, albeit of critically low quality, suggests that robotic surgery decreases estimated blood loss and shortens the time to resumption of oral intake in patients with gastric cancer. There is currently no high-quality evidence that robotic surgery has clinical benefits for gastric cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kitano S, Iso Y, Moriyama M et al (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148

    CAS  PubMed  Google Scholar 

  2. Etoh T, Shiroshita H, Shiraishi N et al (2016) Ongoing clinical studies of minimally invasive surgery for gastric cancer in Japan. Transl Gastroenterol Hepatol 1:31

    Article  PubMed  PubMed Central  Google Scholar 

  3. Shinohara T, Satoh S, Kanaya S et al (2013) Laparoscopic versus open D2 gastrectomy for advanced gastric cancer: a retrospective cohort study. Surg Endosc 27:286–294

    Article  PubMed  Google Scholar 

  4. Kitano S, Shiraishi N, Fujii K et al (2002) A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery 131:S306–311

    Article  PubMed  Google Scholar 

  5. Best LM, Mughal M, Gurusamy KS (2016) Laparoscopic versus open gastrectomy for gastric cancer. Cochrane Database Syst Rev 3:CD01389

    Google Scholar 

  6. Obama K, Sakai Y (2016) Current status of robotic gastrectomy for gastric cancer. Surg Today 46:528–534

    Article  PubMed  Google Scholar 

  7. Hashizume M, Sugimachi K (2003) Robot-assisted gastric surgery. Surg Clin N Am 83:1429–1444

    Article  PubMed  Google Scholar 

  8. Chen K, Pan Y, Zhang B et al (2017) Robotic versus laparoscopic Gastrectomy for gastric cancer: a systematic review and updated meta-analysis. BMC Surg 17:93

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chuan L, Yan S, Pei-Wu Y (2015) Meta-analysis of the short-term outcomes of robotic-assisted compared to laparoscopic gastrectomy. Minim Invasive Ther Allied Technol 24:127–134

    Article  PubMed  Google Scholar 

  10. Duan BS, Zhao J, Xie LF et al (2017) Robotic verse laparoscopic gastrectomy for gastric cancer: a pooled analysis of 11 individual studies. Surg Laparosc Endosc Percutan Tech 27:147–153

    Article  PubMed  Google Scholar 

  11. Guerra F, Giuliani G, Formisano G et al (2018) Pancreatic complications after conventional laparoscopic radical gastrectomy versus robotic radical gastrectomy: systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A 28:1207–1215

    Article  PubMed  Google Scholar 

  12. Hu LD, Li XF, Wang XY et al (2016) Robotic versus laparoscopic gastrectomy for gastric carcinoma: a meta-analysis of efficacy and safety. Asian Pac J Cancer Prev 17:4327–4333

    Article  PubMed  Google Scholar 

  13. Hyun MH, Lee CH, Kim HJ et al (2013) Systematic review and meta-analysis of robotic surgery compared with conventional laparoscopic and open resections for gastric carcinoma. Br J Surg 100:1566–1578

    Article  CAS  PubMed  Google Scholar 

  14. Liao GX, Xie GZ, Li R et al (2013) Meta-analysis of outcomes compared between robotic and laparoscopic gastrectomy for gastric cancer. Asian Pac J Cancer Prev 14:4871–4875

    Article  PubMed  Google Scholar 

  15. Marano A, Young Choi Y, Hyung WJ et al (2013) Robotic versus laparoscopic versus open gastrectomy: a meta-analysis. J Gastr Cancer 13:136–148

    Article  Google Scholar 

  16. Pan JH, Zhou H, Zhao XX et al (2017) Long-term oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a meta-analysis. Surg Endosc 31:4244–4251

    Article  PubMed  Google Scholar 

  17. Shen WS, Xi HQ, Chen L et al (2014) A meta-analysis of robotic versus laparoscopic gastrectomy for gastric cancer. Surg Endosc 28:2795–2802

    Article  PubMed  Google Scholar 

  18. Wang Y, Zhao X, Song Y et al (2017) A systematic review and meta-analysis of robot-assisted versus laparoscopically assisted gastrectomy for gastric cancer. Medicine (Baltimore) 96:e8797

    Article  Google Scholar 

  19. Xiong B, Ma L, Zhang C (2012) Robotic versus laparoscopic gastrectomy for gastric cancer: a meta-analysis of short outcomes. Surg Oncol 21:274–280

    Article  PubMed  Google Scholar 

  20. Xiong J, Nunes QM, Tan C et al (2013) Comparison of short-term clinical outcomes between robotic and laparoscopic gastrectomy for gastric cancer: a meta-analysis of 2495 patients. J Laparoendosc Adv Surg Tech A 23:965–976

    Article  PubMed  Google Scholar 

  21. Zong L, Seto Y, Aikou S et al (2014) Efficacy evaluation of subtotal and total gastrectomies in robotic surgery for gastric cancer compared with that in open and laparoscopic resections: a meta-analysis. PLoS ONE 9:e103312

    Article  PubMed  PubMed Central  Google Scholar 

  22. Shea BJ, Reeves BC, Wells G et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 358:j4008

    Article  PubMed  PubMed Central  Google Scholar 

  23. Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–34

    Article  PubMed  Google Scholar 

  24. Higgins JPT, Green S (editors) (2011) Cochrane handbook for systematic review of intervention 5. 1. 0. The Cochrane Collaboration

  25. Uyama I, Suda K, Nakauchi M et al (2019) Clinical advantages of robotic gastrectomy for clinical stage I/II gastric cancer: a multi-institutional prospective single-arm study. Gastric Cancer 22:377–385

    Article  PubMed  Google Scholar 

  26. Kim HI, Han SU, Yang HK et al (2016) Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma. Ann Surg 263:103–109

    Article  PubMed  Google Scholar 

  27. Kumar A, Tandon S, Samavedi S et al (2016) Current status of various neurovascular bundle-sparing techniques in robot-assisted radical prostatectomy. J Robot Surg 10:187–200

    Article  PubMed  Google Scholar 

  28. Shiroki R, Fukami N, Fukaya K et al (2016) Robot-assisted partial nephrectomy: superiority over laparoscopic partial nephrectomy. Int J Urol 23:122–131

    Article  PubMed  Google Scholar 

  29. Biffi R, Luca F, Bianchi PP et al (2016) Dealing with robot-assisted surgery for rectal cancer: current status and perspectives. World J Gastroenterol 22:546–556

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Hoshino N, Sakamoto T, Hida K et al (2019) Robotic versus laparoscopic surgery for rectal cancer: an overview of systematic reviews with quality assessment of current evidence. Surg Today 49:556–570

    Article  PubMed  Google Scholar 

Download references

Funding

No specific funding.

Author information

Authors and Affiliations

  1. Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Nobuaki Hoshino, Katsuhiro Murakami, Koya Hida, Shigeo Hisamori, Shigeru Tsunoda, Kazutaka Obama & Yoshiharu Sakai

Authors
  1. Nobuaki Hoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katsuhiro Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Koya Hida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigeo Hisamori
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shigeru Tsunoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazutaka Obama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yoshiharu Sakai
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study concept and design. Literature search and data collection were performed by NH and KM. The first draft of manuscript was written by NH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nobuaki Hoshino.

Ethics declarations

Conflict of interest

Kazutaka Obama has received a lecture honorarium from Intuitive Surgical Inc. The other authors declare that they have no conflict of interest.

Human rights and animal participants

This article does not involve human participants or animals.

Informed consent

For this kind of study, formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hoshino, N., Murakami, K., Hida, K. et al. Robotic versus laparoscopic surgery for gastric cancer: an overview of systematic reviews with quality assessment of current evidence. Updates Surg 72, 573–582 (2020). https://doi.org/10.1007/s13304-020-00793-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-020-00793-8

Keywords

Search

Navigation