Evidence map›Paper›PMID 42377470›Full record

SynthesisSurgical endoscopy2026

Short-term surgical outcomes of robotic-assisted versus laparoscopic ileal pouch-anal anastomosis (IPAA): a systematic review and meta-analysis.

James Burns, Abel Abraham, Sameh Hany Emile, Samantha Sipe, Christopher Lopez, Lillian Wagner, Anjelli Wignakumar, Steven D Wexner

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

James BurnsEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Abel AbrahamEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Sameh Hany EmileEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Samantha SipeEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Christopher LopezEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Lillian WagnerEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Anjelli WignakumarEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Steven D WexnerEllen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA. steven.d.wexner@medstar.net.ORCID http://orcid.org/0000-0001-8046-5753

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic and robotic-assisted approaches are increasingly used for ileal pouch-anal anastomosis (IPAA) after restorative proctocolectomy, yet direct comparisons of short-term outcomes are limited. This systematic review compared the collective short-term outcomes of laparoscopic and robotic-assisted IPAA.

methodsA PRISMA-compliant systematic review of PubMed, Scopus, and Cochrane Library was performed (January 2000-June 2025) to identify studies comparing robotic-assisted and laparoscopic IPAA. The primary outcome was 30-day complications and conversion to open surgery. Pairwise meta-analyses and random-effects meta-regression were conducted. The risk of bias was assessed using ROBINS-1 tool; evidence certainty was examined using GRADE.

results8 cohort studies, comprising 1861 patients, were included. 1241 patients (66.7%) underwent laparoscopic IPAA, 620 (33.3%) underwent robotic-assisted IPAA. There were no significant differences in the odds of total (OR 0.97, 95%CI 0.66, 1.41, p = 0.855) or major complications (OR 1.11, 95%CI 0.81, 1.53, p = 0.511). Odds of ileus, small bowel obstruction, and anastomotic leak were comparable. Robotic-assisted IPAA was associated with significantly fewer conversions to open surgery (OR 0.25, 95%CI 0.08, 0.77, p = 0.015) but longer operative times (WMD 24.97, 95%CI 2.09, 47.85, p = 0.032). Blood loss and intraoperative complications did not significantly differ. Meta-regression showed the conversion benefit of robotic IPAA was more pronounced in male patients and those with higher ASA, ulcerative colitis, and 3-stage IPAA.

conclusionsRobotic-assisted and laparoscopic IPAA have comparable short-term complication rates, with robotic-assisted surgery offering significantly lower risk of conversion but longer operative times. These findings confirm robotic-assisted IPAA is an acceptable alternative to laparoscopic IPAA; however, interpretation should be cautious given the observational design of the studies and overall low certainty of evidence. Surgeon expertise in technique and resource availability will influence operative approach.

Indexed as

Colonic PouchesLaparoscopyProctocolectomy, RestorativeRobotic Surgical ProceduresConversion to Open SurgeryHumansOperative TimePostoperative ComplicationsTreatment OutcomeIleal pouch-anal anastomosisIPAALaparoscopicMeta-analysisRobotic-assistedSurgical outcomesSystematic review

Identifiers

PMID42377470

What OpenQuestion holds

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Registered trials

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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.