Table 10.

GRADE summary of findings and certainty of evidence

	Study limitations	Consistency	Directness	Precision	Certainty of evidence
Intraoperative outcomes
Duration of operation	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic > open		Consistent	Direct	Precise	Moderate
Robotic > laparoscopic		Consistent	Direct	Precise	High
Intraoperative complications	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = open		Consistent	Direct	Imprecise	Low
Robotic = laparoscopic		Consistent	Direct	Imprecise	Moderate
Transfusion	Matched observational studies: moderate
Robotic < open		Consistent	Direct	Imprecise	Low
Robotic = laparoscopic		Inconsistent	Direct	Imprecise	Very low
Conversion to open surgery	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = laparoscopic		Inconsistent	Direct	Imprecise	Low
Postoperative short-term outcomes
Length of hospital stay	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic < open		Consistent	Direct	Precise	Moderate
Robotic = laparoscopic		Inconsistent	Direct	Precise	Moderate
Surgical-site infection	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = open		Consistent	Direct	Imprecise	Low
Robotic = laparoscopic		Consistent	Direct	Imprecise	Moderate
Readmissions	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = open		Consistent	Direct	Imprecise	Low
Robotic = laparoscopic		Consistent	Direct	Imprecise	Moderate
Mortality	Unmatched observational studies: high Matched observational studies: moderate
Robotic = open/laparoscopic		Consistent	Direct	Imprecise	Low
Total complications	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic < open		Inconsistent	Indirect	Imprecise	Very low
Robotic = laparoscopic		Inconsistent	Indirect	Imprecise	Low
Postoperative functional outcomes
Pain	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = open		Inconsistent	Indirect	Imprecise	Very low
Robotic = laparoscopic		Inconsistent	Indirect	Imprecise	Low
Hernia recurrence	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = open		–	Direct	Imprecise	Very low
Robotic = laparoscopic		Consistent	Direct	Imprecise	Moderate
Cost
Cost	Unmatched observational studies: high Matched observational studies: moderate RCTs: moderate
Robotic = open		Inconsistent	Indirect	Imprecise	Very low
Robotic > laparoscopic		Inconsistent	Indirect	Imprecise	Low

GRADE, Grading of Recommendations, Assessment, Development, and Evaluation.