SynthesisJournal of robotic surgery2025
Da Vinci-assisted vs laparoscopic nissen fundoplication for GERD: a systematic review and meta-analysis of randomized controlled trials on patient-reported outcomes, dysphagia, and long-term failure.
Synthesis in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Safety of robotic-assisted surgery in redo fundoplication: a systematic review and meta-analysis.Journal of robotic surgery · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The comparative effectiveness of da Vinci robot-assisted versus conventional laparoscopic Nissen fundoplication for gastroesophageal reflux disease remains controversial despite increasing adoption of robotic platforms. Previous meta-analyses have yielded conflicting results regarding patient-centered outcomes and long-term durability. We conducted a systematic review and meta-analysis of randomized controlled trials comparing da Vinci-assisted versus conventional laparoscopic Nissen fundoplication. This review was prospectively registered with PROSPERO (CRD420251139110). We searched MEDLINE, Embase, Cochrane CENTRAL, Web of Science, Scopus, ClinicalTrials.gov, WHO ICTRP, and grey literature sources through August 2025. Primary outcomes included postoperative dysphagia, proton pump inhibitor use, and intraoperative complications. Secondary outcomes encompassed reoperation rates, operative time, length of stay, and conversion to open surgery. Risk ratios and mean differences were calculated using random-effects models. Evidence certainty was assessed using the GRADE methodology. Four randomized controlled trials involving 160 patients (79 robotic, 81 conventional laparoscopic) met the inclusion criteria. No significant differences were observed in early dysphagia (RR 1.05, 95% CI 0.45-2.45), postoperative proton pump inhibitor use (RR 0.97, 95% CI 0.25-3.79), or intraoperative complications (RR 0.43, 95% CI 0.07-2.81). Secondary outcomes showed no differences in reoperation rates (RR 1.65, 95% CI 0.40-6.90), length of hospital stay (MD -0.03 days, 95% CI -0.41 to 0.36), or conversion rates (RR 1.23, 95% CI 0.19-7.99). Operative time demonstrated substantial heterogeneity; sensitivity analysis revealed significantly longer times with robotics when one outlier study was removed (MD 40.28 min, p < 0.00001). Da Vinci robot-assisted and conventional laparoscopic Nissen fundoplication achieve equivalent clinical outcomes with no significant differences in patient-reported outcomes, complications, or long-term effectiveness, while robotic procedures consistently require longer operative times and substantially higher costs without demonstrable clinical benefits. These findings question the routine application of robotic platforms in antireflux surgery until cost-effectiveness and operative efficiency are optimized.
Indexed as
Identifiers
41075046What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.