수술용 로봇기술의 효과성에 대한 체계적 문헌 고찰과 메타분석: 다빈치 시스템을 이용한 완전내시경적 관상동맥우회술을 대상으로
A Systematic Review and Meta Analysis of the Effectiveness of Surgery Robot Technology: Study of Robotic Totally Endoscopic Coronary Artery Bypass using da Vinci Surgical System
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Surgery robot technology is expected to enhance the survival and quality of life of surgery patients and aims to shorten patients' hospital stays and recovery. However, often it is criticized that the technology is overused and misused without evidence of its cost-effectiveness. The purpose of this study is to investigate the effectiveness of robotic totally endoscopic coronary artery bypass using da Vince surgical system by comparing the effectiveness of the robotic surgery and conventional coronary artery bypass graft (CABG). We extracted studies that reported effectiveness of the robotic surgery and conventional CABG from online data bases through systematic literature reviews, performed meta analyses with the extracted study results, and computed effect size from the estimated effectiveness measures of the two methods. A total of 18 studies of the robotic surgery and five studies of the conventional CABG were included in the analyses. We found that the robotic surgery had advantages over the conventional CABG in the mortality rate and the length of stay in intensive care units, whereas the conventional method performed better in success rate, rate of adverse effects, intraoperative conversion rate, and total operating time. The study findings indicated that evidence based and guided adoption and diffusion policy as to the surgical robot technology is needed to achieve expected benefits of the technology and the cost-effectiveness of healthcare delivery.
Abstract
Surgery robot technology is expected to enhance the survival and quality of life of surgery patients and aims to shorten patients' hospital stays and recovery. However, often it is criticized that the technology is overused and misused without evidence of its cost-effectiveness. The purpose of this study is to investigate the effectiveness of robotic totally endoscopic coronary artery bypass using da Vince surgical system by comparing the effectiveness of the robotic surgery and conventional coronary artery bypass graft (CABG). We extracted studies that reported effectiveness of the robotic surgery and conventional CABG from online data bases through systematic literature reviews, performed meta analyses with the extracted study results, and computed effect size from the estimated effectiveness measures of the two methods. A total of 18 studies of the robotic surgery and five studies of the conventional CABG were included in the analyses. We found that the robotic surgery had advantages over the conventional CABG in the mortality rate and the length of stay in intensive care units, whereas the conventional method performed better in success rate, rate of adverse effects, intraoperative conversion rate, and total operating time. The study findings indicated that evidence based and guided adoption and diffusion policy as to the surgical robot technology is needed to achieve expected benefits of the technology and the cost-effectiveness of healthcare delivery.
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