The Da Vinci surgical system significantly reduced length of hospital stay, blood loss, and transfusion rate compared with open and laparoscopic surgery, but increased operative time versus open surgery.
Systematic Review (n=17)
Does the Da Vinci surgical system improve clinical outcomes compared to open and laparoscopic surgery in patients undergoing various surgical procedures?
The Da Vinci surgical system reduces hospital stay, blood loss, and transfusions compared to open and laparoscopic surgery, but increases operative time and costs, with a lack of RCT evidence.
OBJECTIVE: The primary objectives of this rapid assessment were to assess the clinical evidence of Da Vinci surgical system (DVSS) comparing with open procedures and laparoscopic procedures, and in order to provide the evidence for health decision makers and clinician. METHODS: A comprehensive search of electronic databases (EMbase, PubMed, The Cochrane Library, Web of Science, CNKI, VIP, CBM and Wanfang) and HTA websites were completed up to 9 October, 2013. Two reviews (Jiajie Yu and Yingqiang Wang) independently extracted data of the manuscripts, and assessed quality of included studies using AMSTAR tools. Qualitative description and GRADE were used to report the outcomes and evidence quality. OUTCOMES: A total of 17 studies were included: 3 were HTA and 14 were SR/meta-analysis. The included studies focused on prostatectomy, nephrectomy, hysterectomy colorectal surgery, and cardiac surgery. DVSS was shown to be associated with statistically significant reduction in length of hospital stay, blood loss, and transfusion rate compared with open and laparoscopic surgery, but increase in operative time when compared with open surgery. CONCLUSION: Based on the evidence included in this rapid assessment, DVSS has a limited impact on several clinical outcomes. Considering no available data from randomized controlled trials and much higher cost, decisions will be complex and need to be made carefully. Decision makers should cut down the quantity of purchasing and reasonable allocate them.
Yu et al. (Thu,) conducted a systematic review in Patients undergoing prostatectomy, nephrectomy, hysterectomy, colorectal surgery, or cardiac surgery (n=17). Da Vinci surgical system (DVSS) vs. Open surgery and laparoscopic surgery was evaluated on Length of hospital stay, blood loss, transfusion rate, and operative time. The Da Vinci surgical system significantly reduced length of hospital stay, blood loss, and transfusion rate compared with open and laparoscopic surgery, but increased operative time versus open surgery.