Safety and feasibility of the versius robotic surgical system for colorectal resection: proportional meta-analysis of single-arm studies
摘要
Designed to circumvent the ergonomic constraints and technical rigidity inherent in conventional laparoscopy and monolithic robotic units, the Versius Surgical System represents a novel modular approach to minimally invasive surgery. The primary objective of this research was to conduct a single-arm meta-analysis to quantitatively assess the clinical safety, technical feasibility, and perioperative metrics associated with Versius-guided colorectal resections. A systematic and exhaustive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted to identify relevant studies published through December 2025, with the aim of capturing all eligible research in the field up to that date. Eligible studies reporting clinical outcomes of Versius-assisted colorectal surgery were included. A single-arm meta-analysis was carried out using Stata 18 SE. For continuous variables, pooled means and their corresponding 95% confidence intervals (CIs) were calculated, whereas proportional outcomes were combined using the Freeman–Tukey double arcsine transformation to stabilize variance. To investigate potential sources of heterogeneity, both subgroup analyses and sensitivity analyses were performed, ensuring the robustness and reliability of the synthesized results. Eight studies comprising 547 patients were included. The pooled conversion rate to open surgery was 4% (95% CI: 0.02–0.07; I² = 0.31%). The overall postoperative complication rate was 22% (95% CI: 0.15–0.31), with a low major complication rate (Clavien–Dindo ≥ III) of 3% (95% CI: 0.01–0.05). The pooled mean operative time was 242.42 min (95% CI: 197.86–286.99), with subgroup analyses showing shorter operative times for right hemicolectomy (203.97 min) compared with anterior resection (280.80 min). Postoperative recovery was generally favorable, with patients experiencing a mean hospital stay of 6.90 days (95% CI: 6.05–7.75) and a mean time to bowel function recovery of 2.88 days (95% CI: 2.48–3.29). Sensitivity analyses further confirmed the stability and reliability of these pooled estimates, indicating consistency across studies. Versius-assisted colorectal resection appears to be safe and technically feasible, demonstrating low conversion and major complication rates. While operative times suggest an initial learning curve, perioperative and recovery outcomes are comparable to established robotic platforms. Further prospective, multi-center studies are required to assess long-term functional and oncological outcomes.