A systematic review and meta-analysis of the comparative effectiveness and short-term outcomes of the KangDuo and da Vinci robotic platforms in colorectal cancer surgery.

The KangDuo Surgical Robot-01 (KD-SR-01) was developed as a lower-cost alternative, but its perioperative performance relative to da Vinci remains uncertain. This study aims to compare operative efficiency and perioperative safety between the KD-SR-01 and da Vinci systems in colorectal cancer (CRC) surgery. A PROSPERO-registered systematic review (CRD420251082786) searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to 28 June 2025. Randomised controlled trials (RCTs) and comparative cohort studies involving adult CRC patients treated with both robotic platforms were eligible. Primary outcomes were operative time (OT), estimated blood loss (EBL), and docking time; postoperative complications were analysed as secondary outcomes. Random-effects meta-analysis generated weighted mean differences (WMDs) or odds ratios (ORs) with 95% confidence intervals (CIs). Study quality was appraised with ROBINS-I and Cochrane RoB 2 tools. Four studies (2 RCTs, 2 cohorts) enrolling 273 patients (KD-SR-01 = 136; da Vinci = 137) met the criteria. KD-SR-01 was associated with a longer OT (WMD = 25.51 min, 95% CI 11.05-39.96), but a shorter docking time (WMD =  - 0.84 min, 95% CI - 1.58 to - 0.10). No significant differences were observed in EBL (WMD = 8.62 mL, 95% CI - 9.02 to 26.26) or in the rate of postoperative complications (OR = 1.02, 95% CI 0.49-2.21). Cohort studies showed moderate risk of bias; RCTs were judged as low risk or had some concerns. The KD-SR-01 system showed similar intraoperative blood loss, docking time, and safety outcomes compared to the da Vinci platform. However, operative time was significantly longer, which may affect clinical workflow and should be considered in platform selection.