Systematic Review of Robotic-Assisted Peripheral and Central Lymphatic Surgery

Background: Robotic-assisted lymphatic reconstruction has gained increasing interest over the past few years.Objectives:The aim of this study was to systematically investigate the benefits of robotic-assisted lymphatic surgery based oncurrently published literature. Methods: A systematic review evaluating the feasibility, surgical aspects, and both objective and subjective improvements inpatients with impairment of the peripheral or central lymphatic system was performed according to the PRISMA guidelines.The review was registered on PROSPERO. Results: The literature search yielded 328 articles after the removal of duplicates, followed by a full-text review of the 29articles, out of which a total of 11 relevant articles were deemed eligible. Among these, seven used a retrospective design andfour a prospective design. All studies included confirmed the feasibility of robotic-assisted lymphatic surgery and reportedpromising results concerning both technical aspects and patient-related outcomes. However, currently, only a limited numberof studies directly compare the robotic-assisted approach to the manual approach, and these studies have limited statisticalanalyses. Conclusion: Despite the heterogeneous measurands, all studies showed the feasibility of robotic-assisted lymphatic surgery,and seven provided promising data on patient-related outcomes. Additional studies are needed to further identify futuredirections in robotic-assisted lymphatic surgery