Compare The Efficacy Of The Da Vinci Surgical System And Laparoscopy In Liver Operation: A Systematic Review

Objective: Today minimally invasive surgery has enjoyed wide acceptance in thefield of liver surgery, and numerous procedures for this minimally invasive approachhave been developed. Da Vinci robot assisted sugery is an emerging technology thatallows laparoscopic procedures to be followed in many surgical situation. However,its safety and effectiveness in liver surgery is unclear. So the main aim of this studywas to compare the safety and efficacy of Da Vinci robot assisted surgery andlaparoscopic surgery in liver with respect to adult patients.Method: A systematic article search and review were performed. Medline,PubMed, Embase, Science Citation Index, the Cochrane Central Register ofControlled Trials, ACP Journal Club as well as China National KnowledgeInfrastructure(CNKI), China Biology Medicine disc(CBM), Wanfang Database, WebDatabase were used in our study. Published studies comparing Da Vinci robot assistedsugery versus laparoscopic surgery was eligible for inclusion. Newcastle-OttawaScale(NOS) was used to assess the quality of included studies. The main outcome wasblood loss and second outcomes were operation time, postoperative hospital stay,postoperative complication rates. RevMan5.2software was used to do statisticalanalysis. Categorical variables presented in odd ratio(OR) and95%confidenceinterval (CI).Continuous variablespresented in weight mean difference(WMD) and95%confidence interval (CI).Result: Four artical reporting data on215patients have been included in ourstudy, two prospective studies and two retrospective studies. There was no significantdifferences between Da Vinci robot assisted surgery and laparoscopic surgery in blood loss [MD=-2.5（95%CI：-58.46，53.47）,P=0.93], operation time [MD=86.35（95%CI：-11.33，184.03, P=0.08], postoperative hospital stay [MD=0.10（95%CI：-3.01，3.21,P=0.95] and postoperative complication[OR=0.89（95%CI：0.23，3.38, P=0.86].Conclusion: Based on current studies, we cannot concluded Da Vinci robotassisted surgery is better than laparoscopic surgery. We need more well designedmulticenter randomized controlled trial to assess the safety and efficacy of Da Vincirobot assisted surgery.