Robot surgery cuts conversion-to-open rate by 54% vs. laparoscopy, meta-analysis of 13.9 million patients finds

A large-scale global meta-analysis has found that robot-assisted surgery significantly improves patient outcomes in benign (non-cancerous) disease procedures compared with conventional laparoscopic and open surgery.

Intuitive Surgical Korea announced Thursday that a meta-analysis consolidating data from approximately 13.9 million patients with 13 major benign conditions had been published in the international surgical journal Annals of Surgery Open.

The research analyzed 366 clinical and cohort studies published across 32 countries from 2010 to 2024, making it the largest comparative study of surgical approaches for benign diseases on record.

The analysis found that da Vinci robot-assisted surgery reduced the likelihood of intraoperative conversion to open surgery by 54 percent compared with laparoscopic surgery. The risk of blood transfusion fell by 13 percent, average hospital stays shortened by about four hours, and return-to-work timelines were cut by roughly two days. Postoperative pain scores and analgesic use were also lower. However, average operating time was about 24 minutes longer for robotic procedures, and there were no statistically significant differences in complication rates, infection rates or 30-day mortality.

The advantages were more pronounced when robot-assisted surgery was compared with open surgery. The robotic group showed a 69 percent lower likelihood of blood transfusion, a 46 percent reduction in 30-day complication risk and a 60 percent lower risk of surgical site infection. Hospital stays shortened by about two days and return to daily activities came roughly five days sooner, while the likelihood of analgesic use within 30 days fell by 37 percent. Operating time was on average 46 minutes longer than with open surgery.

The study is significant for extending the evidence base for robotic surgery — previously concentrated on complex oncological procedures — into the broader realm of benign disease using large-scale real-world evidence, establishing objective benchmarks for earlier patient recovery and more efficient use of medical resources.

Jamie Wong, chief medical officer at Intuitive, called it "a comprehensive analysis that consolidates the evidence on benign disease surgery previously scattered across hundreds of individual studies," adding that it "will serve as an important clinical reference for clinicians and patients as they discuss and decide on the best course of treatment."