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The following is a summary of “Minimally invasive laparoscopic and robotic anterior lumbar interbody fusion: a systematic review and future directions,” published in the May 2025 issue of BMC Surgery by Decker et al. 

Anterior Lumbar Interbody Fusion (ALIF) was traditionally performed using open or mini-open techniques, but laparoscopic and robotic-assisted approaches have gained attention for offering potential improvements in pain, recovery, and outcomes.  

Researchers conducted a retrospective study to compare the safety, effectiveness, and long-term outcomes of laparoscopic and robotic-assisted ALIF with conventional surgical techniques.  

They performed the systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. MEDLINE and Cochrane databases were explored for studies on laparoscopic and robotic approaches to the anterior spine, focusing on ALIF and 2 reviewers independently screened articles and extracted data. Studies were excluded if they involved animal models and non-ALIF robotic techniques or were not published in English.  

The results showed that 650 articles were initially identified. After screening, 80 underwent full-text review, and 48 met inclusion criteria: 42 examined Laparoscopic ALIF (L-ALIF), and 6 investigated Robotic-Assisted ALIF (R-ALIF) and L-ALIF demonstrated comparable outcomes to mini-open techniques, with minimal consistent advantages, but was associated with a steep learning curve and increased risk of retrograde ejaculation. R-ALIF showed enhanced precision and fewer intraoperative complications. Despite these benefits, its widespread use remained limited due to high cost, logistical demands, and insufficient long-term outcome data.  

Investigators concluded that L-ALIF and R-ALIF offered promising alternatives to mini-open techniques, though their broader use was limited by technical, logistical, and financial challenges. 

Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-025-02890-0