Minimally Invasive Surgical Techniques and Postoperative Outcomes: A Systematic Literature Review

Abstract

Laparoscopic and robotic-assisted surgical procedures, referred to as minimally invasive surgical (MIS), have revolutionized the practice of surgery in the present era by minimizing traumas to the tissues and improving the postoperative outcomes. Although widespread, there is still controversy on their long-term oncological safety, complication rates and cost-effectiveness in different surgical specialties. The purpose of this systematic review and meta-analysis was to synthesize up-to-date evidence on a comparison of minimally invasive and open surgery regarding perioperative outcome, postoperative morbidity, oncolog safety at the long-term, and healthcare utilisation. According to PRISMA, the electronic databases such as PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to find the studies published between 2000 and 2025. Randomised controlled trials, cohort studies, systematic reviews and meta-analyses that assessed the postoperative outcomes of laparoscopic and robotic-assisted surgery were considered. Study selection, data extraction and quality appraisal were conducted by two independent reviewers using validated appraisal tools. The quantitative synthesis was applied where methodological homogeneity was allowed.There were 108 studies that met the inclusion criteria with 64 included in the meta-analysis. Minimally invasive procedures were found to be linked to much less intraoperative blood loss, reduced hospital stay, lower postoperative pain scale, and less rate of surgical site infection as compared to the open surgery. Complication rates in the minimally invasive cohorts were lowered up to about 3045 percent overall. Robotic surgery was also shown to be more precise and had a lower rate of conversion in complex pelvic surgery, but had a longer operative time and a higher direct cost of the procedure. There were no significant differences between the extremely minimal invasive and open procedures in long-term oncological outcome, such as disease-free and overall survival, in colorectal and urologic malignancies; nevertheless, the selected cases of cervical cancer justify caution. In most clinical settings, surgical methods offer advantages of minimally invasive operations that offer better short-term perioperative outcomes and lower morbidity at the expense of cancer safety. Despite the technical benefits of robotic systems in complicated procedures, the cost implications and oncological concerns associated with the procedure make the use of patient selection and institutional experience very critical. Further randomized trials and long-term outcome data, which are of high quality, are necessary to further direct surgical decision-making and maximize patient-centered care.