Comparison of robotic-assisted and laparoscopic-assisted surgery in the treatment of children with Hirschsprung's disease: a systematic review and meta-analysis.

Background: This study aims to systematically evaluate the differences between robotic-assisted surgery (RAS) and laparoscopic-assisted surgery (LAS) in intraoperative parameters, postoperative complications, and prognostic outcomes for children with Hirschsprung's disease (HSCR). By conducting a meta-analysis, evidence-based insights for clinical practice were sought. Methods: Following PRISMA guidelines, PubMed, Embase, and Web of Science were searched up to May 10, 2025, to identify comparative studies of RAS and LAS for HSCR. Two reviewers independently screened literature and assessed quality using the Newcastle-Ottawa Scale ( Results: Six studies involving 789 children (352 RAS, 437 LAS) were included. Meta-analysis showed significantly less intraoperative blood loss in the RAS group (OR = -6.45, 95%CI: -11.77 to -1.14, Conclusions: RAS confers advantages in reducing intraoperative blood loss and shortening hospital stay, although it is associated with a longer operative duration. However, no significant difference in the incidence of postoperative complications was noted between RAS and LAS, a finding potentially attributable to the limited sample size. Furthermore, the currently elevated treatment cost of RAS may impede its widespread adoption due to economic limitations. Consequently, large-sample, multicenter randomized controlled trials with extended follow-up periods are warranted to validate long-term outcomes and conduct in-depth investigations into cost-effectiveness. Systematic Review Registration: PROSPERO CRD420251051595.