Superiority of robotic surgery for cervical cancer in comparison with traditional approaches: A systematic review and meta-analysis

Objectives: To review the safety and effectiveness of da Vinci robotic surgery for cervical cancer in comparison with the traditional open surgery and conventional laparoscopic operation.

Methods: Based on Medline, the Cochrane library, Embase, and the Journal of Robotic Surgery prior to December 30st, 2015, we searched for controlled trials and observational studies. A systematic review with meta-analyses was conducted to compare the clinical efficacy between the da Vinci robotic surgery, open surgery, and laparoscopic surgery for cervical cancer. Data were pooled using the random effects meta-analysis.

Results: Compared with the open surgery, the robotic surgery for cervical cancer would be advantageous in terms of the length of hospital stay, incidence of complications, volume of blood loss and blood transfusion. The operative time of robotic surgery was longer than that of the open surgery, but the prediction intervals indicated that they could be shorter in future studies. Meanwhile, compared with conventional laparoscopic surgery, the robotic surgery could offer more benefits in terms of the length of hospital stay, while no difference was found in terms of the incidence of complications and the volume of blood loss.

Conclusions: Compared to open surgery, the robotic surgery would be advantageous for cervical cancer patients in terms of the length of hospital stay, the incidence of complications, blood loss and blood transfusion. Compared with conventional laparoscopic surgery, the robotic surgery would result in longer OT, more BL and shorter LOS. The study quality was poor.