Abstract

Intracerebral hemorrhage (ICH) is a life-threatening, highly morbid, and mortal condition in the global society. Robotic-assisted surgery has emerged as a novel and progressive approach to enhance accuracy and clinical outcomes in the management of ICH. This meta-analysis and systematic review compared the safety and efficacy of robotic-assisted surgery for the treatment of ICH with conventional surgical methods. In accordance with PRISMA guidelines, the systematic comparison of clinical trials and cohort studies evaluating robotic-assisted and traditional surgical procedures was conducted. Data analysis was performed in RevMan 5.3, with the quality of the studies assessed using the RoB 2 tool for randomized studies and the Newcastle-Ottawa Scale for observational studies. Eleven articles, including 1,200 participants, were included. In comparison with traditional surgery, robotic-assisted surgery was found to reduce operative time by 18.13 minutes, drain age time by 1.65 days, and rebleeding rates. Also, robotic-assisted surgeries were linked to lower infection rates, fewer total complications, less bleeding, and shorter hospitalization. There was no substantial difference in the mortality of the two surgical procedures. All in all, robotic-assisted surgery showed significant improvements in some perioperative and postoperative outcomes, suggesting that robotic technology could increase the efficiency and safety of surgery for intracerebral hemorrhage. However, additional large-scale studies are still warranted to support these results.

Key words: Intracerebral hemorrhage; Robotic-assisted surgery; Conventional neurosurgery; Minimally invasive surgery; Stereotactic hematoma evacuation; Neuroendoscopic surgery; Surgical outcomes; Rebleeding; Postoperative complications; Meta-analysis