Robotic surgery in craniofacial reconstruction: A systematic review of techniques, outcomes, and limitations

The proposed study is a systematic review that will evaluate the application of robotic surgery in craniofacial reconstruction, focusing on the breadth of surgical use, pre- and post-clinical outcomes, and deficiencies in modern practices and perspectives within the field. According to the PRISMA guidelines, the literature search was conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library, and studies published between January 2000 and May 2025 were identified. The terms included the search query, robot surgery, craniofacial reconstruction, and similar. The peer-reviewed articles were accepted as inclusion criteria based on the report on robot use in craniofacial procedures and statistics on methods, outcomes, or limitations. The exclusion criteria were robotic, non-craniofacial, and animal research. The documented information included the study design, patient demographics, robotic systems, anatomical focus, surgical outcomes, and limitations. The Newcastle-Ottawa or the ROBINS-I tool was used to determine quality. Synthesis of narratives was conducted, and homogeneous results were considered for meta-analysis. Various robotic methods, including transoral robotic surgery and endoscopic-assisted techniques, were defined and reviewed for use in cranial vault, orbital, and mandibular reconstruction. Clinical results were more precise, with less blood loss and more aesthetically pleasing outcomes than traditional methods, but also, operative times differed. The risks of complications were reduced, but they still involved nerve damage and infections. Constraints included expense, sharp learning feats, and the inability of instruments to navigate exterior spaces in a pinch. The transformative potential of robotics is evident in the application of robot-assisted surgery for craniofacial reconstruction, which enhances accuracy and improves patient outcomes. Research, however, through randomized trials and the development of specialized instruments, is required due to a lack of technical elements, economic considerations, and evidence to determine its effective integration in the clinical sphere.