AB148. SOH26AB_0076. A systematic review and meta-analysis comparing the perioperative systemic inflammatory response in laparoscopic and robotic colorectal surgery
Colorectal Session II

AB148. SOH26AB_0076. A systematic review and meta-analysis comparing the perioperative systemic inflammatory response in laparoscopic and robotic colorectal surgery

Taya Keating1, Niall Kennedy1, Carolyn Cullinane1, Eoghan Condon1, Colin Peirce1,2, John Calvin Coffey1,2, Christina Fleming1,2

1Department of General Surgery, University Hospital Limerick, Limerick, Ireland; 2School of Medicine, University of Limerick, Limerick, Ireland

Background: Robotic surgery offers greater precision, resulting in reduced tissue trauma and systemic inflammatory response syndrome (SIRS) compared to laparoscopy. The clinical impact of reduced SIRS is a reduction in post-operative pain, lower complication rates, and shorter hospital stay. This systematic review and meta-analysis aimed to compare post-operative trends in biochemical markers of SIRS in laparoscopic and robotic abdominal surgery.

Methods: This systematic review was registered on PROSPERO and performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane were searched, and primary research papers were identified that reported on adult patients undergoing elective colorectal/abdominal surgery in which any measure of perioperative SIRS was compared in laparoscopic versus robotic surgery. Meta-analysis was performed using RevMan (Cochrane, version 7.2.0)

Results: Eight studies were included, analysing data on 1,706 patients. White cell count (WCC) and C-reactive protein (CRP) were the most commonly reported biochemical markers of SIRS. In pooled meta-analysis, CRP post-robotic surgery was significantly lower than laparoscopic surgery on post-operative day 1 (POD1) [odds ratio (OR) =−6.56; 95% confidence interval (CI): −10.85, −2.27; P=0.0006] and POD3 (OR =−18.41; 95% CI: −27.68, −9.15; P<0.0001), particularly following colorectal cancer surgery. Regarding secondary outcome measures, a significantly reduced length of stay (OR =−0.23; 95% CI: −0.41, 0.05; P<0.0001) and lower intra-operative blood loss (OR =−2.58; 95% CI: −3.52, −1.63; P<0.001) was observed in robotic surgery compared to laparoscopy even with longer operative durations (OR =18.32; 95% CI: 12.19, 24.44; P<0.0001).

Conclusions: This meta-analysis demonstrated that post-operative CRP, as a biochemical marker of SIRS, was significantly lower in robotic surgery compared with laparoscopy. This confirms the tissue trauma impact and reduction in SIRS offered by improved precision with robotic surgery platforms.

Keywords: Robotic-assisted surgery; laparoscopic assisted surgery; C-reactive protein (CRP); systemic inflammatory response syndrome (SIRS); colorectal surgery

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab148
Cite this abstract as: Keating T, Kennedy N, Cullinane C, Condon E, Peirce C, Coffey JC, Fleming C. AB148. SOH26AB_0076. A systematic review and meta-analysis comparing the perioperative systemic inflammatory response in laparoscopic and robotic colorectal surgery. Mesentery Peritoneum 2026;10:AB148.

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