O142 The application of robotic surgical approaches in the management of midgut neuroendocrine tumours: a systematic review

Abstract

Abstract Introduction Robotic-assisted surgery (RAS) promises good outcomes in midgut adenocarcinoma surgery. However, its effectiveness in midgut neuroendocrine tumours (MNETs) is unknown. This study aimed to assess the current use, user interface and any emerging developments of RAS in MNET treatment using the literature available. Methods This review was carried out using PRISMA guidelines. MEDLINE, EMBASE and Web of Science were searched on 22nd October 2022. All studies reporting primary data on robotic surgery in midgut neuroendocrine tumours or carcinoid tumours were included. The midgut was defined to be from the duodenojejunal flexure to the splenic flexure. Methodological quality was assessed using the Joanna Briggs critical appraisal tool. Results According to our systematic review protocol, nineteen studies were selected. A total of twenty-six patients were identified. RAS was used for right colectomy, right hemicolectomy, ileal resection, caecal resection, intracorporeal anastomosis and complete mesocolic excision. It offered an optimal user interface with enhanced visuals, fine dexterity, and ergonomic work position. Innovative developments in tumour-healthy tissue boundary and vasculature visualisation were reported. Conclusion Although the evidence base is limited, RAS for MNETs is safe and feasible. We recommend more extensive prospective-randomised controlled trials comparing it with laparoscopy and open surgery. Developments in contrast dyes and tumour-specific probes are very promising.