{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:25:47Z","timestamp":1790173547638,"version":"4.1.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Laparoscopic surgery (Lap) is widely recognized as the standard minimally invasive method for colorectal surgeries. Although robotic surgery (Rob) has seen increased adoption, its application in inflammatory bowel disease remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A systematic search was conducted across PubMed, Scopus, and the Cochrane Central Register of Controlled Trials up to February 2026. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed via the inconsistency (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) statistic. Trial sequential analysis (TSA) was applied to assess the robustness of the cumulative evidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Four observational studies, including 3776 patients, were analyzed; 246 underwent Rob and 3530 underwent Lap. Compared with Lap, Rob was associated with a significantly lower rate of overall postoperative complications (OR: 0.56; 95% CI: 0.31 to 0.99;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .047). No significant differences were observed between approaches in postoperative ileus (OR: 1.16; 95% CI: 0.67 to 2.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .595), anastomotic leak (OR: 0.92; 95% CI: 0.38 to 2.22;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .852), surgical site infection (OR: 0.70; 95% CI: 0.36 to 1.36;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .297), reoperation (OR: 1.00; 95% CI: 0.42 to 2.35;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .997), or stoma formation (OR: 0.47; 95% CI: 0.18 to 1.25;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .130). The length of hospital stay was similar between groups (MD:\n                      <jats:italic toggle=\"yes\">= \u22120.20<\/jats:italic>\n                      days; 95% CI: = \u22120.80 to 0.31;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .37). Operative time was significantly longer in Rob (MD: + 51.8 minutes; 95% CI: 32.0 to 71.6;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). TSA indicated that most outcomes remained underpowered, suggesting a persistent risk of random error.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Rob for Crohn\u2019s disease is a safe and feasible minimally invasive approach, with lower overall postoperative complications than Lap. However, Rob was associated with longer operative times, while most perioperative outcomes remain comparable. Further well-designed prospective studies are required to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261445559","type":"journal-article","created":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T08:43:53Z","timestamp":1776588233000},"page":"568-577","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Robotic Versus Laparoscopic Surgery for Crohn\u2019s Disease: A Systematic Review and Meta-Analysis with Trial Sequential Analysis"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2960-3810","authenticated-orcid":false,"given":"Bernardo Fontel","family":"Pompeu","sequence":"first","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."},{"name":"USCS \u2013 University of S\u00e3o Caetano do Sul, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Vaz","family":"Micherino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Hoici","family":"Brunini","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Leal","family":"Barone","sequence":"additional","affiliation":[{"name":"USCS \u2013 University of S\u00e3o Caetano do Sul, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Monteiro","family":"Delgado","sequence":"additional","affiliation":[{"name":"Federal University of Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorrany Ramos","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana Daneluci","family":"Melillo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1547-2337","authenticated-orcid":false,"given":"Philipe Franco do Amaral","family":"Tafner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Theis","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo de Melo","family":"Del Grande","sequence":"additional","affiliation":[{"name":"Federal University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Mazzola","family":"Poli de Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Bellotti","family":"Formiga","sequence":"additional","affiliation":[{"name":"Department of Surgery, Heliopolis Hospital, S\u00e3o Paulo-SP, Brazil."},{"name":"Department of Colorectal Surgery, Hospital of Santa Casa de Miseric\u00f3rdia, S\u00e3o Paulo, 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Robotic versus laparoscopic surgery for Crohn\u2019s disease: A systematic review and meta-analysis with trial sequential analysis. PROSPERO; 2026. 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