Robotic Surgery Versus Conventional Laparoscopy and Laparotomy for Ovarian Cancer: A Systematic Review and Meta-analysis

Background: This research aimed to evaluate differences in overall survival, recurrence frequency, and both intraoperative and postoperative results in ovarian cancer (OC) patients treated with robotic surgery, laparoscopic procedures, or open laparotomy. Methods: In this study, comprehensive searches were done in PubMed, Web of Science, Embase, and Scopus until September 15, 2023. The main outcome was to compare the association between robotic surgery and other approaches: overall mortality rate, recurrence rate, postoperative and intraoperative complications, blood transfusion, duration of operation, conversion to open, estimated blood loss (EBL), pelvic/para-aortic lymph nodes, and duration of stay in the hospital. Results: Ultimately, a total of 9 studies were included. Robotic surgery had a significant relationship between the lowest EBL and the duration of stay in the hospital in comparison with laparotomy, with a mean difference of -292.26 mL and -3.54 days, respectively. Also, the rate of postoperative complications (OR: 0.41), blood transfusion (OR: 0.03), lower overall mortality (OR: 0.22), and recurrence rate (OR: 0.48) were lower in robotic surgery in comparison with laparotomy. In addition, robotic surgery had significantly shorter operation times than laparoscopy, with a mean difference of -33.21 minutes. Furthermore, the rate of blood transfusion (OR: 0.10) and conversion to open (OR: 0.35) were lower in robotic surgery in comparison with laparotomy. Conclusion: This study demonstrated that robotic surgery could be a safe, viable, and effective alternative for those suffering from OC, offering lower rates of conversion to open surgery and blood transfusion compared to laparoscopy.