Eight studies were included in the review (n=326 patients); all studies were observational. Only one study had a prospective design, although two of the remainder declared prospective data collection. Mean follow-up time ranged from three to 46 months. Three studies were considered to be high quality, scoring 5 points; three studies scored 4 points and two scored 3 points.
Robotic-assisted laparoscopic pyeloplasty was associated with a statistically non-significantly shorter operation time compared to conventional laparoscopic pyeloplasty (WMD -10.4 minutes, 95% CI -24.6 to 3.00; seven studies), with statistically significant heterogeneity.
Hospital stays were statistically significantly shorter following robotic-assisted laparoscopic pyeloplasty than conventional laparoscopic pyeloplasty (WMD -0.5 days, 95% CI -0.6 to -0.4; five studies), although the clinical significance of this was unclear.
There was no statistically significant difference in complication rates between the procedures (OR 0.7, 95% CI 0.3 to 1.6; eight studies).
Success rates were similar for the two procedures (OR 1.3, 95% CI 0.5 to 3.5; eight studies).
Subgroup analysis showed that operative times were significantly shorter for robotic-assisted laparoscopic pyeloplasty in centres with low conventional laparoscopic pyeloplasty experience compared with centres with high experience (for which no significant difference was found between the two procedures); statistical heterogeneity in these subgroups remained high. No other significant differences were found in other subgroup analyses.
Results of funnel plot analyses were not reported.