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Robotic versus open urological oncological surgery: study protocol of a systematic review and meta-analysis
  1. Giovanni E Cacciamani,
  2. Karanvir Gill,
  3. Inderbir S Gill
  1. USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California, USA
  1. Correspondence to Dr Giovanni E Cacciamani; giovanni.cacciamani{at}


Introduction Minimally invasive surgery in urology has grown considerably in application since its initial description in the early 1990s. Herein, we present the protocol for a systematic review and meta-analysis comparing open versus robotic urological oncological surgery for various clinically relevant outcomes, as well as to assess their comparative penetrance over the past 20 years (2000–2020).

Methods and analysis We will document the penetrance of robotic versus open surgery in the urological oncological field using a national database.

Second, we will perform a systematic review and meta-analysis of all published full-text English and non-English language articles from Pubmed, Scopus and Web of Science search engines on surgical treatment of localised prostate, bladder, kidney and testis cancer published between 1st January 2000 to 10th January 2020. We will focus on the highest-volume urological oncological surgeries, namely, radical prostatectomy, radical cystectomy, partial nephrectomy, radical nephrectomy and retroperitoneal lymph node dissection. Study inclusion criteria will comprise clinical trials and prospective and retrospective studies (cohort or case–control series) comparing robotic versus open surgery. Exclusion criteria will comprise meta-analyses, multiple papers with overalapping study-periods, studies analysing national databases and case series describing only one approach (robotic or open). Risk of bias for included studies will be assessed by the appropriate Cochrane risk of bias tool. Principal outcomes assessed will include perioperative, functional, oncological survival and financial outcomes of open versus robotic uro-oncological surgery. Sensitivity analyses will be performed to correlate outcomes of interest with key baseline characteristics and surrogates of surgical expertise.

Ethics and dissemination This comprehensive systematic review and meta-analysis will provide rigorous, consolidated information on contemporary outcomes and trends of open versus robotic urological oncological surgery based on all the available literature. These aggregate data will help physicians better advise patients seeking surgical care for urological cancers.

PROSPERO registration number CRD42017064958.

  • prostate disease
  • bladder disorders
  • kidney tumours
  • urology
  • minimally invasive surgery

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  • Contributors ISG and GEC conceptualised and designed the protocol, drafted the initial manuscript and reviewed the manuscript. ISG and GEC defined the concepts and search items, data extraction process as well as methodological appraisal of the studies. GEC, KG and ISG planned the data extraction and statistical analysis. ISG and GEC provided critical insights. All authors have approved and contributed to the final written manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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