Five RCTs were included in the review (n=181 patients, range from 20 to 50). Two trials reported adequate methods of randomisation and allocation concealment. One trial was single-blind. All trials had incomplete outcome data and selective outcome reporting.
No statistically significant differences were seen between robot-assisted fundoplication and conventional laparoscopic fundoplication for any surgical complication including intraoperative complications, conversion to open surgery, dysphagia, pneumothorax and postoperative antisecretory medication. Heterogeneity was low for all these outcomes (I2 ranged from zero to13%)
Robot-assisted fundoplication prolonged the duration of surgery compared with conventional laparoscopic fundoplication, with a mean difference of 3.17 minutes (95% CI 2.44 to 4; two RCTs; I2=24%).
There were no significant differences between robot-assisted fundoplication and conventional laparoscopic fundoplication for the time needed for hiatal dissection, time from incision to completion of sutures, total operation time, duration of hospital stay, and total costs. Heterogeneity for all these outcomes was high (I2 ranged from 82 to 97%).