| Robotics Compared to Laparoscopy: Gynecologic Oncology | ||||||
|---|---|---|---|---|---|---|
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Laparoscopy | Robotic | |||||
| Length of Hospitalization | The mean length of hospitalization in the intervention groups was 0.2 lower (0.31 to 0.1 lower) | 636 (5 studies) | □□⊖⊖ low1 |
RB > LP | ||
| Complications | Study population | OR 0.76 (0.52 to 1.09) | 970 (10 studies) | □□⊖⊖ low1,2 |
n/a | |
| 163 per 1000 | 129 per 1000 (92 to 175) | |||||
| Medium risk population | ||||||
| 206 per 1000 | 165 per 1000 (119 to 220) | |||||
| Operation Time | The mean operation time in the intervention groups was 0.03 higher (0.47 lower to 0.53 higher) | 870 (7 studies) | □⊖⊖⊖ very low1,3 |
n/a | ||
| Blood Loss | The mean blood loss in the intervention groups was 74.95 lower (94.77 to 55.14 lower) | 636 (5 studies) | □□⊖⊖ low1 |
RB > LP | ||
| Conversions | Study population | OR 0.38 (0.2 to 0.72) | 640 (3 studies) | □□⊖⊖ low1 |
RB > LP | |
| 100 per 1000 | 41 per 1000 (22 to 74) | |||||
| Medium risk population | ||||||
| 52 per 1000 | 20 per 1000 (11 to 38) | |||||
| Lymph Nodes | The mean lymph nodes in the intervention groups was 3.16 lower (6.99 lower to 0.67 higher) | 870 (7 studies) | □□⊖⊖ low4 |
n/a | ||
The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
RB > LP indicates that robotics had a more favourable profile for the specific outcome; RB < LP indicates robotics had a less favourable profile for the specific outcome.
CI: Confidence interval; OR: Odds ratio; RB: Robotics; LP: Laparoscopy.
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.
Level of surgeon skill differed across studies.
Complications were reported differently across studies.
Inconsistency not explained by level of surgeon skill or patient characteristics
Extensive laparoscopic experience may have facilitated the uptake of robotic surgery.