Robot-assisted surgeries still require additional time and costs to deploy, not to mention that they're not necessarily safer or more successful than their human counterparts, a new study reveals.

A systematic review conducted by the University of Texas assessed 50 published randomized controlled trials that include over 4,800 patients - examining the quality of evidence and outcomes in robot-assisted open surgery and comparing it with laparoscopy, open surgery, or a combination of both.

The University of Texas researchers presented their study in the article "The Evidence Behind Robot-Assisted Abdominopelvic Surgery," included in the latest issue of Annals of Internal Medicine.

Robot Assisted Surgery
(Photo: Franciscan Health Website via Wikimedia Commons)

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The Increasing Use of Robot-Assisted Surgeries

In their studies, researchers noted how robot-assisted surgeries have dramatically surged since their first uses back in the 1980s. Now, almost all applications previously exclusive to human surgeons and specific subspecialties have adopted a form of robot-assisted procedure, one way or the other.

Data sources for the study include PubMed, the free online search engine that accesses the MEDLINE database on medicinal studies and more; EMBASE: the biomedical and pharmacological database of published studies; SCOPUS: the abstract and citation database managed by information analytics leader Elsevier; and the Cochrane Central Register of Controlled Trials. The study involved two reviewers who independently extracted the study data used.

In the 50 studies analyzed, 39 of them reported cases of Clavien-Dindo complications, 4 cases (or ten percent) of them showed fewer complications through robot-assisted surgery. In most of the studies, researchers found no significant difference in the use of robot-assisted procedures in terms of intraoperative complications, conversion rates, and long-term outcomes in patients.

Additionally, researchers report that while robot-assisted surgery took a long time compared to laparoscopy, there was no obvious difference when it was compared to open surgery.

These findings led researchers to conclude that "there is currently no clear advantage with existing robotic platforms, which are costly and increase operative duration." Additionally, the University of Texas authors noted that factors such as refinement of existing methods, having competition, cost reduction, and future innovations could lead to improved clinical outcomes in the use of robot-assisted surgeries.

About Robot-Assisted Surgery

The first robot used in a surgical setting was the Arthrobot, developed and used in Vancouver, Canada, in 1985, according to The Medical Post, and was used in manipulating and adjusting the position of a patient's leg via voice commands. Since then, robots for surgical applications have seen steady growth - both in sophistication and in volume.

However, it has not seen universal use and acceptance, having been criticized for the costs involved in using robot-assisted procedures. In 2007, the average costs ranged from  $5,607 to $45,914, as reported in an article published in The New England Journal of Medicine. Additionally, a 2020 study on the BMC Medical Informatics and Decision Making inquired on the public awareness, understanding, and attitudes toward the use of robot-assisted surgery in Kuwait. The public survey in the Middle Eastern population revealed the lack of awareness and limited understanding toward technological advancement but showed a positive response in adopting the method.


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