To systematically evaluate the impact of robotic-assisted digestive endoscopic systems versus conventional manual operation on ESD in animal experimental models.

Searches were performed in databases including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, VIP, and CBM from inception to December 2025 to identify animal studies comparing robotic-assisted ESD with conventional ESD.According to the intervention methods of the included studies, the experimental subjects were divided into a robotic-assisted group and a conventional group.Two researchers independently screened the literature and extracted data.Meta-analysis was conducted using RevMan 5.4 and StataMP 18.The primary outcome measures were en bloc resection rate and blind dissection rate; secondary outcomes included total procedure time, submucosal dissection time, and dissection speed.

Eleven animal experimental studies (ex vivo and in vivo) were included.Robotic assistance significantly increased the en bloc resection rate (OR=8.35, 95%CI: 2.63, 26.56, P=0.0 003) and reduced the blind dissection rate (MD=-19.49, 95%CI: -25.03, -13.95, P<0.00 001). Total procedure time MD=-14.23 min, 95%CI: -18.99, -9.48, P<0.00 001) and submucosal dissection time (MD=-10.48 min, 95%CI: -16.83, -4.13, P<0.00 001) were significantly shorter in the robotic-assisted group. Dissection speed was also higher (MD=30.85 mm²/min, 95%CI: 18.54, 43.17, P=0.0 003). Egger′s test for the total procedure time indicated no significant publication bias (P=0.147), and publication bias assessment was not performed for the remaining outcome indicators due to the limited number of included studies.

Based on current animal evidence, robotic-assisted endoscopic systems can optimize the surgical field, demonstrating clear advantages in improving the en bloc resection rate of ESD, reducing the risk of blind cutting, and shortening operative time.