A comprehensive review and meta-analysis comparing robot-assisted and laparoscopic adrenalectomy in individuals with obesity.

ABSTRACT

This meta-analysis aimed to compare the efficacy of robot-assisted vs. laparoscopic adrenalectomy in individuals with obesity. We performed an extensive review of the PubMed, Embase, and Cochrane Library databases for research on adrenalectomy in individuals with obesity up to August 2024. Only studies comparing robot-assisted surgery with laparoscopic surgery were included. Only articles written in English were included. We utilized established criteria for inclusion and exclusion, concentrating on randomized controlled trials and cohort studies. The ROBINS-I instrument was employed to assess the bias risk in non-randomized control studies. Review Manager 5.4.1 was utilized to conduct the meta-analysis. The final analysis incorporated four retrospective cohort studies with a total of 492 individuals with obesity (261 receiving RA and 231 undergoing LA). The results showed that RA was linked to a shorter duration of hospitalization and less estimated blood loss in comparison to LA. Nonetheless, there were no notable distinctions between the two surgical methods in terms of OT, laparotomy conversion rates, overall postoperative complications, or death rates after surgery. In conclusion, RA is a reliable and safe choice for individuals with obesity. It offers notable advantages over LA in terms of LOHS and EBL.