Comparison of the Hinotori surgical robot with the da Vinci robotic system in urologic surgery: a systematic review and meta-analysis

The objective is to investigate the outcomes of the Hinotori Surgical Robotic System (HSRS) for urological surgery and to analyze the variation in perioperative performance between the HSRS and the da Vinci surgical robot. Multiple databases including PubMed, Cochrane Library, Embase and Web of Science were comprehensibly retrieved to screen studies that applied HSRS to urologic surgery and compared it with the da Vinci system. The results were combined and analyzed using estimated ratio of ratios (OR) and weighted mean difference (WMD). Eight studies with 740 patients were included. Among the baseline characteristics of patients in both groups, all outcomes showed similarity. In urologic surgery, the HSRS cohort experienced a longer operative time (WMD = 8.85, 95% Cl (1.73, 15.97), p < 0.05) and a relatively longer use of the robotic system (WMD = 10.77, 95% Cl [1.09, 20.44], p < 0.05), as well as a notable increase in console time (WMD = 20.99, 95% Cl 95% Cl [8.24, 33.75], p < 0.05). However, estimated blood loss, length of hospitalization, rate of severe complications, and rate of positive margins did not show statistical differences. In urologic surgery, HSRS has a longer operative time, robot system usage time, and console time, but its perioperative results are similar to the Da Vinci system. HSRS shows good clinical promise, however, further long-term data studies are needed to prove it.