Cost and cost-effectiveness of robotic-assisted pyeloplasty compared to laparoscopic pyeloplasty in patients with pelviureteric junction obstruction: a systematic review protocol.

OBJECTIVE

This systematic review will evaluate the costs and cost-effectiveness of robot-assisted pyeloplasty and laparoscopic pyeloplasty in patients with pelviureteric junction obstruction.

INTRODUCTION

Pelviureteric junction obstruction is the most common congenital abnormality of the urinary tract, affecting approximately 1 in every 1500 live births. Pyeloplasty is the standard treatment, with approaches including open, laparoscopic, and robot-assisted techniques. Although robotics offers advantages such as enhanced precision, concerns remain regarding its cost and cost-effectiveness compared to laparoscopic pyeloplasty, especially in resource-limited settings.

ELIGIBILITY CRITERIA: The review will include studies involving pediatric and adult patients diagnosed with pelviureteric junction obstruction undergoing robot-assisted pyeloplasty or laparoscopic pyeloplasty. Studies focusing on outcomes related to resource utilization, costs, and cost-effectiveness for robot-assisted pyeloplasty and laparoscopic pyeloplasty, as well as cost analyses with and without comparators, will be included.

METHODS

The review will follow the JBI guidelines for the systematic review of economic evaluation evidence. A comprehensive search will be conducted among academic and non-academic databases and gray literature. Screening, data extraction, and critical appraisal will be conducted independently by 2 reviewers, with adjudication by a third reviewer. Where feasible, meta-analyses will be performed using incremental net benefit for cost-effectiveness data; otherwise, findings will be presented as a narrative synthesis. JBI's Dominance Ranking Matrix for economic evaluations will be used to summarize and compare the results of cost-effectiveness studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence for outcomes related to resource use.

REVIEW REGISTRATION: PROSPERO CRD420251036657.