Surgeon task load, ergonomics, and clinical outcomes in laparoscopic versus robotic-assisted inguinal hernia repair: a systematic review and meta-analysis of randomized controlled trials.
Anna Rümmele-Vogt, Julian Süsstrunk, Marie-Thérèse Böttcher et al.
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In 30 seconds
This systematic review and meta-analysis examined randomized controlled trials comparing robotic-assisted (RIHR) with conventional laparoscopic inguinal hernia repair (LIHR), focusing on surgeon workload, ergonomics, and clinical outcomes. Four trials included 482 patients, with a broad range of surgeon experience. Operative time varied across studies, and the pooled difference was not statistically significant (MD 17.14; 95% CI -3.22 to 37.49). Task load also showed no significant difference (MD -4.50; 95% CI -16.78 to 7.78), while postoperative complication rates were similar overall.
Key findings
- The pooled operative-time difference was not significant (MD 17.14; 95% CI -3.22 to 37.49); three trials reported longer RIHR times and one reported shorter times.
- The pooled task-load estimate slightly favored RIHR but was not significant (MD -4.50; 95% CI -16.78 to 7.78).
- Postoperative complications did not differ significantly overall (OR 0.89, 95% CI 0.42 to 1.90).
- Ergonomics findings were mixed: one study favored RIHR, while another found comparable ergonomics.
Why it matters
The review addresses whether robotic assistance offers measurable advantages for surgeons as well as patients. Across the available randomized trials, it found no significant pooled benefit in task load or operative time, and complication rates were similar. These findings help frame expectations about ergonomic and clinical differences while highlighting that results varied between studies.
What to keep in mind
Only four trials were identified, and surgeon experience varied substantially between them. Ergonomics and task load were reported inconsistently, limiting the evidence available for pooled assessment.