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The safety and effectiveness of Da Vinci surgical system compared with open surgery and laparoscopic surgery: a rapid assessment
Author(s) -
Yu Jiajie,
Wang Yingqiang,
Li Youping,
Li Xianglian,
Li Cuicui,
Shen Jiantong
Publication year - 2014
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12099
Subject(s) - medicine , cochrane library , open surgery , randomized controlled trial , open prostatectomy , medline , surgery , laparoscopic surgery , laparoscopy , general surgery , prostatectomy , cancer , political science , law , prostate
Objective The primary objectives of this rapid assessment were to assess the clinical evidence of Da Vinci surgical system (DVSS) comparing with open procedures and laparoscopic procedures, and in order to provide the evidence for health decision makers and clinician. Methods A comprehensive search of electronic databases (EMbase, PubMed, The Cochrane Library, Web of Science, CNKI, VIP, CBM and Wanfang) and HTA websites were completed up to 9 October, 2013. Two reviews (Jiajie Yu and Yingqiang Wang) independently extracted data of the manuscripts, and assessed quality of included studies using AMSTAR tools. Qualitative description and GRADE were used to report the outcomes and evidence quality. Outcomes A total of 17 studies were included: 3 were HTA and 14 were SR/meta‐analysis. The included studies focused on prostatectomy, nephrectomy, hysterectomy colorectal surgery, and cardiac surgery. DVSS was shown to be associated with statistically significant reduction in length of hospital stay, blood loss, and transfusion rate compared with open and laparoscopic surgery, but increase in operative time when compared with open surgery. Conclusion Based on the evidence included in this rapid assessment, DVSS has a limited impact on several clinical outcomes. Considering no available data from randomized controlled trials and much higher cost, decisions will be complex and need to be made carefully. Decision makers should cut down the quantity of purchasing and reasonable allocate them.