title: Complications of robotic foregut surgery: risks and advantages.
abstract: BACKGROUND
  Laparoscopic foregut surgeries are highly complex procedures that carry a high potential for morbidity and mortality should complications should occur. The robotic-assisted platform offers improved visualization of anatomy, optimal fine motor control, and a higher degree of instrumentation range of motion, which may potentially lead to better outcomes. This paper reviews the risks and benefits of the robotic platform in foregut procedures.
  
  
  METHODS
  A web-based literature search was performed, in August 2016 using Pubmed, EMBASE, and Google Scholar from cited English publications from 1996 to 2016. We included randomized control trials, non-randomized comparison studies, and cohort studies in robotic foregut surgery. Abstracts, letters, editorials, expert opinions, review papers, and meta-analyses with no original statistical analyses were not included.
  
  
  RESULTS
  A total of 619 articles were identified of which 98 articles met the inclusion criteria. The studies were divided into areas of benign and malignant foregut procedures that utilized robotic assistance. Intraoperative complications related to both the surgery itself as well as robotic hardware malfunction, short-term and long-term clinical outcomes were extracted.
  
  
  CONCLUSIONS
  Intraoperative and postoperative complications of robotic assistance during foregut surgery are comparable or superior to those of traditional laparoscopic techniques. Our review suggests improved outcomes in Heller myotomies, gastrectomies, and esophagectomies.
authors: Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA - r4luo@ucsd.edu.
authors: Ran B
authors: RB
authors: Luo
authors: Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA.
authors: Domingo
authors: D
authors: Montalvo
authors: Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA.
authors: Toshiaki
authors: T
authors: Suzuki
authors: Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA.
authors: Bryan J
authors: BJ
authors: Sandler
authors: Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA.
authors: Garth R
authors: GR
authors: Jacobsen
authors: Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA, USA.
authors: Santiago
authors: S
authors: Horgan
mesh_terms: D004931:Esophageal Achalasia / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D019317:Evidence-Based Medicine; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D041981:Gastrointestinal Tract / Q000601:surgery; D000074434:Heller Myotomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D065287:Robotic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome