Introduction Robotic general surgery, a cutting-edge technology, is increasingly used in elective general surgery, demonstrating advantages over laparoscopy in certain cases. While laparoscopy remains standard for common acute abdominal conditions, the role of robotic surgery is uncertain. This systematic review compares outcomes in acute general surgery for robotic versus laparoscopic surgery.

Methods A PRISMA-compliant systematic search of MEDLINE, EMBASE, Science Citation Index-Expanded and Cochrane Library was conducted. Outcome measures were recorded for perioperative outcomes of emergency general surgery in laparoscopic versus robotic cases, and a descriptive analysis performed.

Results Six articles, compared outcomes of robotic and laparoscopic procedures for cholecystectomies, ileocaecal resection, subtotal colectomy, hiatal hernia and perforated gastrojejunal ulcer repair. Laparoscopic bowel resection in inflammatory bowel disease patients had higher complications; for other operations, no significant differences were found. Operative time showed no differences for cholecystectomies, but robotic approaches were longer for other procedures. Robotic cases had shorter length of stay, but associated costs were higher.

Conclusions Perioperative outcomes for acute robotic surgery in selected general surgery conditions are comparable to laparoscopic surgery. Recommending robotic surgery in the acute setting requires a well-powered large population study for stronger evidence.