Robotic surgery versus Laparoscopic surgery for anti-reflux and hiatal hernia surgery: a short-term outcomes and cost systematic literature review and meta‐analysis

Category	Detail
Condition	Gastroesophageal Reflux Disease (GERD) and hiatal hernias
Key Mechanisms	Minimally invasive surgical techniques including laparoscopic surgery (LS) and robotic-assisted surgery (RS) for anti-reflux and hiatal hernia repair
Target Population	Adult patients undergoing curative-intent surgery for GERD and/or hiatal hernia
Care Setting	Surgical care in hospital operating rooms with postoperative inpatient monitoring

Laparoscopic surgery is the current standard offering reduced postoperative discomfort, shorter hospital stays, and faster recovery.
Robotic-assisted surgery provides enhanced 3D visualization, improved dexterity, and ergonomic benefits potentially aiding complex dissections and suturing.
Cost-effectiveness and definitive clinical superiority of robotic surgery over laparoscopic surgery remain under debate.

Diagnosis based on clinical evaluation and indication for surgical intervention in GERD and hiatal hernia.

Selection between robotic-assisted and laparoscopic approaches should consider surgical expertise, patient safety, and healthcare economics.
Both RS and LS are minimally invasive options for anti-reflux and hiatal hernia surgery.

Postoperative monitoring includes assessment of complications, length of stay, readmission rates, and mortality.

Potential intraoperative complications and conversion to open surgery should be anticipated.
Cost implications and resource utilization differ between RS and LS.

Adults with GERD and/or hiatal hernia undergoing minimally invasive surgery

Both robotic and laparoscopic surgeries are viable; choice depends on surgical expertise, patient factors, and cost considerations.

Ensure surgical team proficiency in chosen minimally invasive technique to optimize outcomes.
Consider patient-specific factors and hernia complexity when selecting surgical approach.
Use validated tools like MINORS to assess study quality and guide evidence-based practice.
Apply random effects models in meta-analyses to account for clinical heterogeneity.
Balance technological advantages of robotic surgery against cost and evidence of clinical benefit.

Clinical Scorecard: Comparative Analysis of Short-Term Outcomes and Costs in Robotic versus Laparoscopic Approaches for Anti-Reflux and Hiatal Hernia Surgery: A Systematic Review and Meta-Analysis