Robotic-assisted versus conventional coronary artery bypass grafting: a systematic review, meta-analysis, and trial sequential analysis of 39,918 patients

Robotic-assisted coronary artery bypass grafting (RA-CABG) is an evolving minimally invasive alternative to conventional CABG (C-CABG), but comparative evidence remains fragmented. We conducted a comprehensive systematic review, meta-analysis, and trial sequential analysis to compare outcomes between RA-CABG and C-CABG.

Following PRISMA 2020 guidelines, we searched PubMed, Embase, Cochrane CENTRAL, and Web of Science through January 2026. Studies comparing RA-CABG to C-CABG reporting at least one outcome of interest were eligible. Random-effects meta-analyses using DerSimonian-Laird estimators were performed. Risk of bias was assessed using ROBINS-I. Trial sequential analysis evaluated the conclusiveness of cumulative evidence.