Systematic review of operative outcomes of robotic surgical procedures performed with endoscopic linear staplers or robotic staplers

Abstract

A comprehensive review of operative outcomes of robotic surgical procedures performed with the da Vinci robotic system using either endoscopic linear staplers (ELS) or robotic staplers is not available in the published literature. We conducted a literature search to identify publications of robotic surgical procedures in all specialties performed with either ELS or robotic staplers. Twenty-nine manuscripts and six abstracts with relevant information on operative outcomes published from January 2011 to September 2017 were identified. Given the relatively recent market release of robotic staplers in 2014, comparative perioperative clinical outcomes data on the performance of ELS vs. robotic staplers in robotic surgery is very sparse in the published literature. Only three comparative studies of surgeries with the da Vinci robotic system plus ELS vs. da Vinci plus robotic staplers were identified; two in robotic colorectal surgery and the other in robotic gastric bypass surgery. These comparative studies illustrate some nuances in device design and usability, which may impact outcomes and cost, and therefore may be important to consider when selecting the appropriate stapling technologies/technique for different robotic surgeries. Comparative perioperative data on the use of ELS vs. robotic staplers in robotic surgery is scarce (three studies), and current literature identifies both types of devices as safe and effective. Given the longer clinical history of ELS and its relatively more robust evidence base, there may be trade-offs to consider before switching to robotic staplers in certain robotic procedures. However, this literature review may serve as an initial reference for future research.

Robotic stapler use: Is it safe?–FDA database analysis across multiple surgical specialties

“…Another retrospective analyses noted similar operative outcomes for RS use in colorectal surgery with respect to EBL, operating time, LOS, and complications [ 7 ]. A 2019 systematic review of operative outcomes of robotic surgical procedures performed with laparoscopic linear staples or robotic staplers concluded very little perioperative data is available on the use of laparoscopic versus robotic staplers [ 8 ]. We hope that our retrospective comparison of our RS and LS outcomes for living-donor nephrectomies contributes to this important topic.…”

Robot-assisted thoracoscopic surgery using a narrow-profile vascular stapler through an 8-mm robotic port

“…Although a robotic stapler is usually used, it is such a ‘mottainai’ that the endoscopic surgical stapler used during thoracoscopic biopsy was not utilized in the following RATS. Although a robotic stapler is easy to use, additional use of a robotic stapler after VATS lung biopsy is more expensive [ 2 , 3 ]. In endoscopic surgery, various automatic linear staplers are used depending on the thickness, length and location of the vessels [ 4 , 5 ].…”

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

“…We decided to use an external linear stapler operated by the assistant. It is also feasible to use a robotically controlled linear stapler [34], for which a 12-mm da Vinci trocar is needed and has to be placed somewhat different to achieve a sufficient distance to the target organ.…”