Supplementary material - Perioperative outcomes in robotic, laparoscopic and open distal pancreatectomy: a network meta-analysis

Nasser Abdul Halim, Eran Sadot, Ionut Negoi

Table of Contents

1.	Age of the patients	16

2.	Sex of patients	27

3.	ASA status	31

4.	Previous cardiovascular diseases	36

5.	Operative time	46

6.	Conversion to open	56

7.	Intraoperative blood loss	64

8.	Intraoperative bleeding more than 500 ml	76

9.	Number of patients receiving transfusions	78

10.	The quantity of blood tranfusion	81

11.	ICU stay	84

12.	Reintervention rate	88

13.	Hospital stay	93

14.	Readmission rate	103

15.	In-hospital mortality	107

16.	30-day mortality	115

17.	90-day major complications	124

Supplementary Figure 1: Individual study results grouped by treatment comparison for the outcome Age.	15

Supplementary Figure 2: Network plot of all studies for outcome Age. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	16

Supplementary Figure 3: Forest plot for outcome age. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	16

Supplementary Figure 4: Summary Forrest Plot for outcome Age. Ranking of the interventions based on the SUCRA value.	18

Supplementary Figure 5: Bayesian random effect consistency model forrest plot for outcome Age. Between studies standard deviation 2.31, 95% credible interval 1.67 to 3.06.	19

Supplementary Figure 6: Litmus Rank-O-Gram: Outcomes Age. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	20

Supplementary Figure 7: Radial SUCRA plot: Outcomes Age. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	21

Supplementary Figure 8: Residual deviance from NMA model and UME inconsistency model for all studies.	22

Supplementary Figure 9: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	22

Supplementary Figure 10: Leverage plot for all studies.	23

Supplementary Figure 11: Metaregression for the outcome Age having as covariate the year of study publication.	24

Supplementary Figure 12: Forrest plot of metaregression for the outcome age having as covariate the year of the study publication.	25

Supplementary Figure 13: Metaregression for the outcome Age having as covariate the number of patients in the included studies.	25

Supplementary Figure 14: Individual study results grouped by treatment comparison for the outcome Sex.	26

Supplementary Figure 15: Network plot of all studies for outcome Sex. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	27

Supplementary Figure 16: Forest plot for outcome Sex. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	28

Supplementary Figure 17: Summary Forrest Plot for outcome Sex. Ranking of the interventions based on the SUCRA value.	29

Supplementary Figure 18: Individual study results grouped by treatment comparison for the outcome ASA I-II.	30

Supplementary Figure 19: Network plot of all studies for outcome ASA I-II. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	31

Supplementary Figure 20: Bayesian random effect consistency model forrest plot for outcome ASA I-II. Between studies standard deviation 0.49, 95% credible interval 0.26 to 0.77.	31

Supplementary Figure 21: Litmus Rank-O-Gram: Outcomes ASA I-II. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	32

Supplementary Figure 22: Radial SUCRA plot: Outcomes ASA I-II. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	33

Supplementary Figure 23: Inconsistency test with nodesplitting model for all studies for outcome ASA I-II.	33

Supplementary Figure 24: Metaregression for the outcome ASA I-II having as covariate the year of study publication.	34

Supplementary Figure 25: Individual study results grouped by treatment comparison for the outcome cardiovascular diseases.	35

Supplementary Figure 26: Network plot of all studies for outcome cardiovascular diseases. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	36

Supplementary Figure 27: Forest plot for outcome cardiovascular diseases. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively. Between-study standard deviation (log-odds scale): 0 , Number of studies: 12 , Number of treatments: 3	36

Supplementary Figure 28: Summary Forrest Plot for outcome cardiovascular diseases. Ranking of the interventions based on the SUCRA value.	38

Supplementary Figure 29: Bayesian random effect consistency model forrest plot for outcomecardiovascular diseases. Between-study standard deviation (log-odds scale): 0.27 . 95% credible interval: 0.01 , 0.77 .	39

Supplementary Figure 30: Litmus Rank-O-Gram: Outcomes cardiovascular diseases. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	40

Supplementary Figure 31: Radial SUCRA plot: Outcomes cardiovascular diseases. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	41

Supplementary Figure 32: Nodesplit model for the outcome operative duration.	41

Supplementary Figure 33: Residual deviance from NMA model and UME inconsistency model for all studies.	42

Supplementary Figure 34: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	42

Supplementary Figure 35: Leverage plot for all studies.	43

Supplementary Figure 36: Regression plot for the outcome cardiovascular diseases having as covariate the year of study publication.	44

Supplementary Figure 37: Individual study results grouped by treatment comparison for the outcome operative time.	45

Supplementary Figure 38: Network plot of all studies for outcome operative time. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively	46

Supplementary Figure 39: Forest plot for outcome operative time. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	46

Supplementary Figure 40: Summary Forrest Plot for outcome operative time. Ranking of the interventions based on the SUCRA value.	48

Supplementary Figure 41: Bayesian random effect consistency model forrest plot for outcome operative duration. Between studies standard deviation 51.49, 95% credible interval 41.93 to 63.28.	49

Supplementary Figure 42: Litmus Rank-O-Gram: Outcomes operative duration. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	50

Supplementary Figure 43: Radial SUCRA plot: Outcomes operative time. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	51

Supplementary Figure 44: Inconsistency test with nodesplitting model for all studies for outcome opertative durationI.	51

Supplementary Figure 45: Residual deviance from NMA model and UME inconsistency model for all studies.	52

Supplementary Figure 46: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	52

Supplementary Figure 47: Leverage plot for all studies.	53

Supplementary Figure 48: Regression plot for the outcome operative duration having as covariate the year of study publication.	53

Supplementary Figure 49: Regression plot for the outcome operative duration having as covariate the number of patients in the included studies.	54

Supplementary Figure 50: Individual study results grouped by treatment comparison for the outcome conversions to open.	55

Supplementary Figure 51: Network plot of all studies for outcome conversions. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	56

Supplementary Figure 52: Forest plot for outcome conversions. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively. Between-study standard deviation (log-odds scale): 0.2 , Number of studies: 37 , Number of treatments: 2. All outcomes are versus the reference treatment: Laparoscopic	56

Supplementary Figure 53: Litmus Rank-O-Gram: Outcomes conversions. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	57

Supplementary Figure 54: Forrest plot of metaregression for the outcome conversions having as covariate the number of patients in the included studies. Between-study standard deviation (log-odds scale): 0.39 . 95% credible interval: 0.02 , 0.81 .	58

Supplementary Figure 55: : Litmus Rank-O-Gram: Outcomes conversions. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	59

Supplementary Figure 56: Radial SUCRA plot: Outcomes conversions. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	60

Supplementary Figure 57: Convergence assessment plots for the outcomes conversion.	61

Supplementary Figure 58: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	62

Supplementary Figure 59: Leverage plot for all studies.	62

Supplementary Figure 60: Individual study results grouped by treatment comparison for the outcome Intraoperative blood loss.	63

Supplementary Figure 61: Network plot of all studies for outcome Intraoperative bleeding. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	64

Supplementary Figure 62: Forest plot for outcome Intraoperative bleeding. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	64

Supplementary Figure 63: Summary Forrest Plot for outcome Intraoperative bleeding. Ranking of the interventions based on the SUCRA value.	66

Supplementary Figure 64: Bayesian random effect consistency model forrest plot for outcome Intraoperative bleeding. Between studies standard deviation 139.19, 95% credible interval 109.56 to 177.58.	66

Supplementary Figure 65: Litmus Rank-O-Gram: Outcomes Intraoperative bleeding. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	67

Supplementary Figure 66: Radial SUCRA plot: Outcomes Intraoperative bleeding. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	68

Supplementary Figure 67: The nodesplit model for the Bayesian NMA.	68

Supplementary Figure 68: Residual deviance from NMA model and UME inconsistency model for all studies.	69

Supplementary Figure 69: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	69

Supplementary Figure 70: Leverage plot for all studies.	70

Supplementary Figure 71: The summary characteristic plot having as co-variate year of publication across al treatment arms.	71

Supplementary Figure 72: Metaregression for the outcome Intraoperative bleeding having as covariate the year of study. publication.	72

Supplementary Figure 73: Forrest plot of metaregression for the outcome intraoperative bleeding having as covariate the year of the study publication.	73

Supplementary Figure 74: Metaregression for the outcome Intraoperative bleeding having as covariate the number of patients in the included studies.	73

Supplementary Figure 75: Forrest plot of metaregression for the outcome intraoperative bleeding having as covariate the number of patients in the included studies.	74

Supplementary Figure 76: Network plot of all studies for outcome intraoperative bleeding more 500 ml. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	75

Supplementary Figure 77. Forest plot for outcome intraoperative bleeding more 500 ml.	75

Supplementary Figure 78: Individual study results grouped by treatment comparison for the outcome patients receiving blood transfusion.	77

Supplementary Figure 79: Network plot of all studies for outcome patients receiving blood transfusion. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	78

Supplementary Figure 80: Forest plot for outcome Number of patients receiving blood transfusions.	78

Supplementary Figure 81: Summary Forrest Plot for outcome number of patients having blood tranfusuions. Ranking of the interventions based on the SUCRA value.	79

Supplementary Figure 82: Individual study results grouped by treatment comparison for the outcome quantity blood transfused.	80

Supplementary Figure 83: Network plot of all studies for outcome quantity of blood transfused. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	81

Supplementary Figure 84: Forest plot for outcome quantity of blood transfused. Between-study standard deviation: 0.53 , Number of studies: 3, Number of treatments: 3. All outcomes are versus the reference treatment: Open.	81

Supplementary Figure 85: Individual study results grouped by treatment comparison for the outcome ICU stay.	83

Supplementary Figure 86: Network plot of all studies for outcome ICU stay. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	84

Supplementary Figure 87: Forest plot for outcome ICU stay. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	84

Supplementary Figure 88: Summary Forrest Plot for outcome ICU stay. Ranking of the interventions based on the SUCRA value.	86

Supplementary Figure 89: Network plot of all studies for outcome reintervention rate. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	87

Supplementary Figure 90: Bayesian random effect consistency model forrest plot for outcome reintervention rate.	87

Supplementary Figure 91: Litmus Rank-O-Gram: Outcomes reintervention rate. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	88

Supplementary Figure 92: Radial SUCRA plot: Outcomes reintervention rate. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	89

Supplementary Figure 93: Nodesplit model for the outcome reintervention rate.	89

Supplementary Figure 94: Residual deviance from NMA model and UME inconsistency model for all studies.	90

Supplementary Figure 95: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	90

Supplementary Figure 96: Leverage plot for all studies.	91

Supplementary Figure 97: Individual study results grouped by treatment comparison for the outcome hospital stay.	92

Supplementary Figure 98: Network plot of all studies for outcome hospital stay. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	93

Supplementary Figure 99: Forest plot for outcome hospital stay. Between-study standard deviation: 2.07 , Number of studies: 63 , Number of treatments: 3. All outcomes are versus the reference treatment: Open.	93

Supplementary Figure 100: Summary Forrest Plot for outcome hospital stay. Ranking of the interventions based on the SUCRA value.	95

Supplementary Figure 101: Bayesian random effect consistency model forrest plot for outcome hospital stay. Between-study standard deviation: 10.86 . 95% credible interval: 9.14 , 12.96 .	95

Supplementary Figure 102: Litmus Rank-O-Gram: Outcomes hospital stay. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	96

Supplementary Figure 103: Radial SUCRA plot: Outcomes hospital stay. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	97

Supplementary Figure 104: Nodesplit model for the outcome hospital stay.	98

Supplementary Figure 105: Residual deviance from NMA model and UME inconsistency model for all studies.	98

Supplementary Figure 106: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	99

Supplementary Figure 107: Leverage plot for all studies.	99

Supplementary Figure 108: Regression plot for the outcome hospital stay having as covariate the year of study publication.	100

Supplementary Figure 109: Regression plot for the outcome hospital stay having as covariate the number of patients in the inlcuded studies.	101

Supplementary Figure 110: Individual study results grouped by treatment comparison for the outcome readmission rate.	102

Supplementary Figure 111: Network plot of all studies for outcome readmission rate. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	103

Supplementary Figure 112: Forest plot for outcome readmission rate. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively. Between-study standard deviation (log-odds scale): 0.22 , Number of studies: 29 , Number of treatments: 3.	103

Supplementary Figure 113: Summary Forrest Plot for outcome readmission rate. Ranking of the interventions based on the SUCRA value.	105

Supplementary Figure 114: Individual study results grouped by treatment comparison for the outcome in-hospital mortality.	106

Supplementary Figure 115: Network plot of all studies for outcome in-hospital mortality. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	107

Supplementary Figure 116: Forest plot for outcome in-hospital mortality. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	107

Supplementary Figure 117: Bayesian random effect consistency model forrest plot for outcome in-hospital mortality.	108

Supplementary Figure 118: Litmus Rank-O-Gram: Outcomes in-hospital mortality. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	108

Supplementary Figure 119: Radial SUCRA plot: Outcomes in-hospital mortality. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	109

Supplementary Figure 120: Residual deviance from NMA model and UME inconsistency model for all studies.	110

Supplementary Figure 121: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	110

Supplementary Figure 122: Leverage plot for all studies.	111

Supplementary Figure 123: Regression plot for the outcome in-hospital mortality having as covariate the year of study publication.	112

Supplementary Figure 124: Regression plot for the outcome in-hospital mortality having as covariate the number of patients in included studies.	113

Supplementary Figure 125: Individual study results grouped by treatment comparison for the outcome 30-day mortality.	114

Supplementary Figure 126: Network plot of all studies for outcome 30-day mortality. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	115

Supplementary Figure 127: Forest plot for outcome 30-day mortality. With red – prediction intervals.	115

Supplementary Figure 128: P-scores Heatmap for the outcome 30-day mortality.	115

Supplementary Figure 129: Forest plot for outcome 30-day mortality. Between-study standard deviation (log-odds scale): 0 , Number of studies: 20 , Number of treatments: 3. All outcomes are versus the reference treatment: Open.	116

Supplementary Figure 130: Summary Forrest Plot for outcome 30-day mortality. Ranking of the interventions based on the SUCRA value.	117

Supplementary Figure 131: Nodesplit model for the outcome 30-day mortality.	118

Supplementary Figure 132: evaluation of inconsistency in CINEMA.	118

Supplementary Figure 133: Residual deviance from NMA model and UME inconsistency model for all studies.	118

Supplementary Figure 134: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	119

Supplementary Figure 135: Leverage plot for all studies.	119

Supplementary Figure 136: Regression plot for the outcome 30-day mortality having as covariate the year of study publication.	120

Supplementary Figure 137: Forrest plot of metaregression for the outcome 30-day mortality having as covariate the year of the study publication.	120

Supplementary Figure 138: Regression plot for the outcome 30-day mortality having as covariate the number of patients in the included studies.	121

Supplementary Figure 139: Forrest plot of metaregression for the outcome 30-day mortality having as covariate the number of patiemts in theincluded studies.	122

Supplementary Figure 140: Publication bias evaluation for the outcomes 30-day mortality.	122

Supplementary Figure 141: Individual study results grouped by treatment comparison for the outcome 90-day major complications.	123

Supplementary Figure 142: Network plot of all studies for outcome 90-day major complications. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.	124

Supplementary Figure 143: Forest plot for outcome 90-day major complications. Between-study standard deviation (log-odds scale): 0.25 , Number of studies: 3 , Number of treatments: 3. All outcomes are versus the reference treatment: Open	124

Supplementary Figure 144: Summary Forrest Plot for outcome 90-day major complications. Ranking of the interventions based on the SUCRA value.	126

Supplementary Figure 145: Bayesian random effect consistency model forrest plot for outcome 90-day major complications. Between-study standard deviation (log-odds scale): 0.37 . 95% credible interval: 0.02 , 0.78 .	126

Supplementary Figure 146: Litmus Rank-O-Gram: Outcomes 90-day major complications. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.	127

Supplementary Figure 147: Radial SUCRA plot: Outcomes 90-day major complications. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.	128

Supplementary Figure 148: Nodesplit model for the outcome 90-day major complications.	128

Supplementary Figure 149: Residual deviance from NMA model and UME inconsistency model for all studies.	129

Supplementary Figure 150: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.	129

Supplementary Figure 151: Leverage plot for all studies.	130

Supplementary Figure 152: Regression plot for the outcome 90-day major complications having as covariate the year of study publication.	131

Supplementary Table 1: Comparison of all treatment pairs related to outcome age. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	17

Supplementary Table 2: Assessment of inconsistency for all studies related to outcome age.	17

Supplementary Table 3: Treatment effects for all studies: comparison of all treatment pairs. Outcomes Age. Bayesian NMA.	19

Supplementary Table 4: Comparison of all treatment pairs related to outcome Sex. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.	28

Supplementary Table 5: Assessment of inconsistency for all studies related to outcome Sex.	28

Supplementary Table 6: Treatment effects for all studies: comparison of all treatment pairs. Outcomes ASA I-II class. Bayesian NMA.	32

Supplementary Table 7: Comparison of all treatment pairs related to outcome cardiovascular diseases. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.	37

Supplementary Table 8: Assessment of inconsistency for all studies related to outcome cardiovascular diseases.	37

Supplementary Table 9: Treatment effects for all studies: comparison of all treatment pairs. Outcomes Age. Bayesian NMA.	39

Supplementary Table 10: Comparison of all treatment pairs related to outcome operative time. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	47

Supplementary Table 11: Assessment of inconsistency for all studies related to outcome operative time.	47

Supplementary Table 12: Treatment effects for all studies: comparison of all treatment pairs. Outcomes operative duration. Bayesian NMA.	49

Supplementary Table 13: Comparison of all treatment pairs related to outcome conversions. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	56

Supplementary Table 14: Treatment effects for all studies: comparison of all treatment pairs. Outcomes conversions. Bayesian NMA.	57

Supplementary Table 15: Comparison of all treatment pairs related to outcome intraoperative bleeding. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	65

Supplementary Table 16: Assessment of inconsistency for all studies related to outcome Intraoperative bleeding.	65

Supplementary Table 17: Treatment effects for all studies: comparison of all treatment pairs. Outcomes Intraoperative bleeding. Bayesian NMA.	67

Supplementary Table 18: Comparison of all treatment pairs related to outcome intraoperative bleeding more 500 ml. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	76

Supplementary Table 19: Assessment of inconsistency for all studies related to outcome intraoperative bleeding more 500 ml.	76

Supplementary Table 20: Comparison of all treatment pairs related to outcome number of patients receiving transfusions. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	78

Supplementary Table 21: Assessment of inconsistency for all studies related to outcome number of patients with blood transfusions.	79

Supplementary Table 22: Comparison of all treatment pairs related to outcome quantity of blood transfused. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.	81

Supplementary Table 23: Assessment of inconsistency for all studies related to outcome quantity of blood transfused.	82

Supplementary Table 24: Comparison of all treatment pairs related to outcome ICU stay. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	85

Supplementary Table 25: Assessment of inconsistency for all studies related to outcome ICU stay.	85

Supplementary Table 26: Treatment effects for all studies: comparison of all treatment pairs. Outcomes reinterention rate. Bayesian NMA.	88

Supplementary Table 27: Comparison of all treatment pairs related to outcome hospital stay. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.	94

Supplementary Table 28: Assessment of inconsistency for all studies related to outcome hospital stay.	94

Supplementary Table 29: Treatment effects for all studies: comparison of all treatment pairs. Outcomes hospital stay. Bayesian NMA.	96

Supplementary Table 30: Comparison of all treatment pairs related to outcome readmission rate. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.	104

Supplementary Table 31: Assessment of inconsistency for all studies related to outcome readmission rate.	104

Supplementary Table 32: Comparison of all treatment pairs related to outcome 30-day mortality. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	116

Supplementary Table 33: CINEMA league table.	116

Supplementary Table 34: Assessment of inconsistency for all studies related to outcome 30-day mortality.	116

Supplementary Table 35: Comparison of all treatment pairs related to outcome 90-day major complication. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies	125

Supplementary Table 36: Assessment of inconsistency for all studies related to outcome 90-day major complications.	125

Supplementary Table 37: Treatment effects for all studies: comparison of all treatment pairs. Outcomes 90-day major complications. Bayesian NMA.	127

Age of the patients

Frequentist NMA

Supplementary Figure 1: Individual study results grouped by treatment comparison for the outcome Age.

Supplementary Figure 2: Network plot of all studies for outcome Age. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 3: Forest plot for outcome age. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Table 1: Comparison of all treatment pairs related to outcome age. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic	Open
Robotic	Robotic	-1.05 [-2.08; -0.01]	-0.56 [-2.56; 1.44]
Laparoscopic	-0.93 [-1.93; 0.07]	Laparoscopic	-0.81 [-2.02; 0.40]
Open	-1.65 [-3.00; -0.30]	-0.72 [-1.86; 0.41]	Open

Supplementary Table 2: Assessment of inconsistency for all studies related to outcome age.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	29	-0.723973410787378	-0.812458112785672	-0.0612322414621663	-0.751225871323505	-4.27796626325485	2.77551452060783	0.676320699561054
2	Laparoscopic:Robotic	36	0.929452011571375	1.04788795803302	-0.557945876299199	1.60583383433222	-2.2052431588584	5.41691082752285	0.408889403280084
3	Robotic:Open	8	-1.65342542235875	-0.558195556917817	-2.57282517064541	2.01462961372759	-0.695797411577971	4.72505663903316	0.145166360271871

Supplementary Figure 4: Summary Forrest Plot for outcome Age. Ranking of the interventions based on the SUCRA value.

Bayesian NMA

Supplementary Figure 5: Bayesian random effect consistency model forrest plot for outcome Age. Between studies standard deviation 2.31, 95% credible interval 1.67 to 3.06.

Supplementary Table 3: Treatment effects for all studies: comparison of all treatment pairs. Outcomes Age. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	0.74 (-0.43, 1.95)	-0.93 (-1.97, 0.11)
Open	-0.74 (-1.95, 0.43)	Open	-1.67 (-3.11, -0.27)
Robotic	0.93 (-0.11, 1.97)	1.67 (0.27, 3.11)	Robotic

Supplementary Figure 6: Litmus Rank-O-Gram: Outcomes Age. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 7: Radial SUCRA plot: Outcomes Age. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 8: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 9: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 10: Leverage plot for all studies.

Meta-regression

Supplementary Figure 11: Metaregression for the outcome Age having as covariate the year of study publication.

Supplementary Figure 12: Forrest plot of metaregression for the outcome age having as covariate the year of the study publication.

Supplementary Figure 13: Metaregression for the outcome Age having as covariate the number of patients in the included studies.

Sex of patients

Supplementary Figure 14: Individual study results grouped by treatment comparison for the outcome Sex.

Supplementary Figure 15: Network plot of all studies for outcome Sex. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Frequentist NMA

Supplementary Figure 16: Forest plot for outcome Sex. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Table 4: Comparison of all treatment pairs related to outcome Sex. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.

Robotic	Laparoscopic	Open
Robotic	Robotic	0.93 [0.85; 1.03]	0.80 [0.66; 0.97]
Laparoscopic	0.95 [0.87; 1.05]	Laparoscopic	0.76 [0.69; 0.84]
Open	0.73 [0.64; 0.82]	0.76 [0.69; 0.84]	Open

Supplementary Table 5: Assessment of inconsistency for all studies related to outcome Sex.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	30	-0.271830774746157	-0.271361599594625	-0.275494240048995	0.00413264045437062	-0.300358622614517	0.308623903523259	0.978777833257442
2	Laparoscopic:Robotic	38	0.0464732854921395	0.0702441678965956	-0.202156546233755	0.272400714130351	-0.0596669069425284	0.60446833520323	0.107880790993562
3	Robotic:Open	9	-0.318304060238297	-0.221004495020797	-0.385434711687796	0.164430216666999	-0.0819791720529211	0.410839605386918	0.19090934530982

Supplementary Figure 17: Summary Forrest Plot for outcome Sex. Ranking of the interventions based on the SUCRA value.

ASA status

Supplementary Figure 18: Individual study results grouped by treatment comparison for the outcome ASA I-II.

Supplementary Figure 19: Network plot of all studies for outcome ASA I-II. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 20: Bayesian random effect consistency model forrest plot for outcome ASA I-II. Between studies standard deviation 0.49, 95% credible interval 0.26 to 0.77.

Supplementary Table 6: Treatment effects for all studies: comparison of all treatment pairs. Outcomes ASA I-II class. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	0.78 (0.56, 1.07)	0.96 (0.74, 1.27)
Open	1.29 (0.94, 1.78)	Open	1.24 (0.87, 1.8)
Robotic	1.04 (0.79, 1.35)	0.81 (0.56, 1.15)	Robotic

Supplementary Figure 21: Litmus Rank-O-Gram: Outcomes ASA I-II. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 22: Radial SUCRA plot: Outcomes ASA I-II. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 23: Inconsistency test with nodesplitting model for all studies for outcome ASA I-II.

Supplementary Figure 24: Metaregression for the outcome ASA I-II having as covariate the year of study publication.

Previous cardiovascular diseases

Supplementary Figure 25: Individual study results grouped by treatment comparison for the outcome cardiovascular diseases.

Supplementary Figure 26: Network plot of all studies for outcome cardiovascular diseases. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 27: Forest plot for outcome cardiovascular diseases. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively. Between-study standard deviation (log-odds scale): 0 , Number of studies: 12 , Number of treatments: 3

Supplementary Table 7: Comparison of all treatment pairs related to outcome cardiovascular diseases. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.

Laparoscopic	Robotic	Open
Laparoscopic	Laparoscopic	1.19 [0.72; 1.96]	0.90 [0.65; 1.24]
Robotic	0.95 [0.61; 1.48]	Robotic	1.38 [0.69; 2.73]
Open	0.94 [0.69; 1.29]	0.99 [0.62; 1.61]	Open

Supplementary Table 8: Assessment of inconsistency for all studies related to outcome cardiovascular diseases.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	9	-0.0589911754875715	-0.10448583790025	0.611094786196309	-0.71558062409656	-1.99066465408722	0.559503405894102	0.271359521448009
2	Laparoscopic:Robotic	6	-0.053808157500433	0.171951107094265	-0.90428458829858	1.07623569539284	-0.0157623030011989	2.16823369378689	0.0533998621161568
3	Robotic:Open	3	-0.00518301798713842	0.318458973627791	-0.311010458364345	0.629469431992135	-0.329478964763673	1.58841782874794	0.198250323793178

Supplementary Figure 28: Summary Forrest Plot for outcome cardiovascular diseases. Ranking of the interventions based on the SUCRA value.

Supplementary Figure 29: Bayesian random effect consistency model forrest plot for outcomecardiovascular diseases. Between-study standard deviation (log-odds scale): 0.27 . 95% credible interval: 0.01 , 0.77 .

Supplementary Table 9: Treatment effects for all studies: comparison of all treatment pairs. Outcomes Age. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	1.07 (0.73, 1.6)	0.9 (0.46, 1.49)
Open	0.94 (0.62, 1.37)	Open	0.84 (0.41, 1.45)
Robotic	1.11 (0.67, 2.16)	1.19 (0.69, 2.44)	Robotic

Supplementary Figure 30: Litmus Rank-O-Gram: Outcomes cardiovascular diseases. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 31: Radial SUCRA plot: Outcomes cardiovascular diseases. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 32: Nodesplit model for the outcome operative duration.

Supplementary Figure 33: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 34: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 35: Leverage plot for all studies.

Supplementary Figure 36: Regression plot for the outcome cardiovascular diseases having as covariate the year of study publication.

Operative time

Supplementary Figure 37: Individual study results grouped by treatment comparison for the outcome operative time.

Supplementary Figure 38: Network plot of all studies for outcome operative time. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively

.

Supplementary Figure 39: Forest plot for outcome operative time. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Table 10: Comparison of all treatment pairs related to outcome operative time. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Open	Laparoscopic	Robotic
Open	Open	-12.10 [-28.09; 3.89]	-12.20 [-39.77; 15.37]
Laparoscopic	-7.63 [-22.85; 7.59]	Laparoscopic	-20.82 [-34.43; -7.21]
Robotic	-25.93 [-44.18; -7.68]	-18.30 [-31.49; -5.12]	Robotic

Supplementary Table 11: Assessment of inconsistency for all studies related to outcome operative time.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	30	7.63057203841852	12.1007915581876	-35.7965387734342	47.8973303316219	-4.43763996737038	100.232300630614	0.0728494516830057
2	Laparoscopic:Robotic	39	-18.3019383111563	-20.8212053430887	20.141979312067	-40.9631846551557	-95.8401371440765	13.913767833765	0.143460472484556
3	Robotic:Open	10	25.9325103495748	12.2002790921557	36.6451707549976	-24.4448916628419	-61.2233420304397	12.3335587047559	0.19267887385987

Supplementary Figure 40: Summary Forrest Plot for outcome operative time. Ranking of the interventions based on the SUCRA value.

Supplementary Figure 41: Bayesian random effect consistency model forrest plot for outcome operative duration. Between studies standard deviation 51.49, 95% credible interval 41.93 to 63.28.

Supplementary Table 12: Treatment effects for all studies: comparison of all treatment pairs. Outcomes operative duration. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	-7.84 (-26.94, 11.24)	19.32 (2.74, 36.27)
Open	7.84 (-11.24, 26.94)	Open	27.17 (4.27, 50.33)
Robotic	-19.32 (-36.27, -2.74)	-27.17 (-50.33, -4.27)	Robotic

Supplementary Figure 42: Litmus Rank-O-Gram: Outcomes operative duration. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 43: Radial SUCRA plot: Outcomes operative time. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 44: Inconsistency test with nodesplitting model for all studies for outcome opertative durationI.

Supplementary Figure 45: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 46: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 47: Leverage plot for all studies.

Supplementary Figure 48: Regression plot for the outcome operative duration having as covariate the year of study publication.

Supplementary Figure 49: Regression plot for the outcome operative duration having as covariate the number of patients in the included studies.

Conversion to open

Supplementary Figure 50: Individual study results grouped by treatment comparison for the outcome conversions to open.

Supplementary Figure 51: Network plot of all studies for outcome conversions. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 52: Forest plot for outcome conversions. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively. Between-study standard deviation (log-odds scale): 0.2 , Number of studies: 37 , Number of treatments: 2. All outcomes are versus the reference treatment: Laparoscopic

Supplementary Table 13: Comparison of all treatment pairs related to outcome conversions. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic
Robotic	Robotic	0.41 [0.34; 0.49]
Laparoscopic	0.41 [0.34; 0.49]	Laparoscopic

Supplementary Table 14: Treatment effects for all studies: comparison of all treatment pairs. Outcomes conversions. Bayesian NMA.

Laparoscopic	Robotic
Laparoscopic	Laparoscopic	0.35 (0.25, 0.44)
Robotic	2.88 (2.27, 4.03)	Robotic

Supplementary Figure 53: Litmus Rank-O-Gram: Outcomes conversions. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 54: Forrest plot of metaregression for the outcome conversions having as covariate the number of patients in the included studies. Between-study standard deviation (log-odds scale): 0.39 . 95% credible interval: 0.02 , 0.81 .

Supplementary Figure 55: : Litmus Rank-O-Gram: Outcomes conversions. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 56: Radial SUCRA plot: Outcomes conversions. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 57: Convergence assessment plots for the outcomes conversion.

Supplementary Figure 58: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 59: Leverage plot for all studies.

Intraoperative blood loss

Supplementary Figure 60: Individual study results grouped by treatment comparison for the outcome Intraoperative blood loss.

Supplementary Figure 61: Network plot of all studies for outcome Intraoperative bleeding. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Frequentist NMA

Supplementary Figure 62: Forest plot for outcome Intraoperative bleeding. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Table 15: Comparison of all treatment pairs related to outcome intraoperative bleeding. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopy	Open
Robotic	Robotic	-38.79 [ -63.70; -13.88]	-239.38 [-302.09; -176.67]
Laparoscopy	-30.45 [ -54.66; -6.25]	Laparoscopy	-260.63 [-297.53; -223.74]
Open	-279.45 [-318.28; -240.61]	-248.99 [-283.41; -214.57]	Open

Supplementary Table 16: Assessment of inconsistency for all studies related to outcome Intraoperative bleeding.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopy:Open	23	-248.992286829271	-260.632974653398	-170.790127240655	-89.8428474127432	-192.342970684633	12.6572758591469	0.0858081232482131
2	Laparoscopy:Robotic	32	30.453697002749	38.7897986061359	-110.135388602818	148.925187208954	43.6274860770919	254.222888340816	0.00557085249117154
3	Robotic:Open	6	-279.44598383202	-239.383118954338	-304.370743338983	64.9876243846459	-14.8806189013062	144.855867670598	0.110758286671654

Supplementary Figure 63: Summary Forrest Plot for outcome Intraoperative bleeding. Ranking of the interventions based on the SUCRA value.

Bayesian NMA

Supplementary Figure 64: Bayesian random effect consistency model forrest plot for outcome Intraoperative bleeding. Between studies standard deviation 139.19, 95% credible interval 109.56 to 177.58.

Supplementary Table 17: Treatment effects for all studies: comparison of all treatment pairs. Outcomes Intraoperative bleeding. Bayesian NMA.

Laparoscopy	Open	Robotic
Laparoscopy	Laparoscopy	272.89 (209.01, 340.15)	-31.17 (-81.92, 19.44)
Open	-272.89 (-340.15, -209.01)	Open	-303.98 (-382.8, -229.26)
Robotic	31.17 (-19.44, 81.92)	303.98 (229.26, 382.8)	Robotic

Supplementary Figure 65: Litmus Rank-O-Gram: Outcomes Intraoperative bleeding. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 66: Radial SUCRA plot: Outcomes Intraoperative bleeding. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 67: The nodesplit model for the Bayesian NMA.

Supplementary Figure 68: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 69: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 70: Leverage plot for all studies.

Meta-regression

Supplementary Figure 71: The summary characteristic plot having as co-variate year of publication across al treatment arms.

Supplementary Figure 72: Metaregression for the outcome Intraoperative bleeding having as covariate the year of study. publication.

Supplementary Figure 73: Forrest plot of metaregression for the outcome intraoperative bleeding having as covariate the year of the study publication.

Supplementary Figure 74: Metaregression for the outcome Intraoperative bleeding having as covariate the number of patients in the included studies.

Supplementary Figure 75: Forrest plot of metaregression for the outcome intraoperative bleeding having as covariate the number of patients in the included studies.

Intraoperative bleeding more than 500 ml

Supplementary Figure 76: Network plot of all studies for outcome intraoperative bleeding more 500 ml. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 77. Forest plot for outcome intraoperative bleeding more 500 ml.

Supplementary Table 18: Comparison of all treatment pairs related to outcome intraoperative bleeding more 500 ml. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic	Open
Robotic	Robotic	0.33 [0.03; 3.24]	.
Laparoscopic	0.33 [0.03; 3.24]	Laparoscopic	0.32 [0.23; 0.46]
Open	0.11 [0.01; 1.07]	0.32 [0.23; 0.46]	Open

Supplementary Table 19: Assessment of inconsistency for all studies related to outcome intraoperative bleeding more 500 ml.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	1	-1.13060420374009	-1.13060420374009	NA	NA	NA	NA	NA
2	Laparoscopic:Robotic	1	1.11541940698449	1.11541940698449	NA	NA	NA	NA	NA
3	Robotic:Open	0	-2.24602361072458	NA	-2.24602361072458	NA	NA	NA	NA

Number of patients receiving transfusions

Supplementary Figure 78: Individual study results grouped by treatment comparison for the outcome patients receiving blood transfusion.

Supplementary Figure 79: Network plot of all studies for outcome patients receiving blood transfusion. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 80: Forest plot for outcome Number of patients receiving blood transfusions.

Supplementary Table 20: Comparison of all treatment pairs related to outcome number of patients receiving transfusions. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic	Open
Robotic	Robotic	0.90 [0.69; 1.17]	0.25 [0.17; 0.38]
Laparoscopic	0.85 [0.66; 1.10]	Laparoscopic	0.29 [0.23; 0.37]
Open	0.25 [0.19; 0.34]	0.30 [0.24; 0.37]	Open

Supplementary Table 21: Assessment of inconsistency for all studies related to outcome number of patients with blood transfusions.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	13	-1.21714010979183	-1.22278490114182	-1.17274006277716	-0.0500448383646597	-0.721427925317185	0.621338248587865	0.883845959949681
2	Laparoscopic:Robotic	20	0.157897493463074	0.107548647007187	1.03278155891915	-0.925232911911965	-2.05326846279931	0.202802638975376	0.107924126915767
3	Robotic:Open	4	-1.3750376032549	-1.37970398196641	-1.37034216051701	-0.00936182144940401	-0.585382703017054	0.566659060118246	0.9745881175923

Supplementary Figure 81: Summary Forrest Plot for outcome number of patients having blood tranfusuions. Ranking of the interventions based on the SUCRA value.

The quantity of blood tranfusion

Supplementary Figure 82: Individual study results grouped by treatment comparison for the outcome quantity blood transfused.

Supplementary Figure 83: Network plot of all studies for outcome quantity of blood transfused. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 84: Forest plot for outcome quantity of blood transfused. Between-study standard deviation: 0.53 , Number of studies: 3, Number of treatments: 3. All outcomes are versus the reference treatment: Open.

Supplementary Table 22: Comparison of all treatment pairs related to outcome quantity of blood transfused. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.

Robotic	Laparoscopic	Open
Robotic	Robotic	0.08 [-1.01; 1.17]	-2.94 [-5.30; -0.58]
Laparoscopic	-0.12 [-1.14; 0.89]	Laparoscopic	-1.50 [-2.95; -0.05]
Open	-1.98 [-3.42; -0.54]	-1.86 [-3.12; -0.59]	Open

Supplementary Table 23: Assessment of inconsistency for all studies related to outcome quantity of blood transfused.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	1	-1.85866556272519	-1.5	-3.02	1.52	-1.45914525650088	4.49914525650088	0.317310507862914
2	Laparoscopic:Robotic	1	0.124125444295657	-0.0800000000000001	1.44	-1.52	-4.49914525650088	1.45914525650088	0.317310507862913
3	Robotic:Open	1	-1.98279100702085	-2.94	-1.42	-1.52	-4.49914525650088	1.45914525650088	0.317310507862914

ICU stay

Supplementary Figure 85: Individual study results grouped by treatment comparison for the outcome ICU stay.

Supplementary Figure 86: Network plot of all studies for outcome ICU stay. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 87: Forest plot for outcome ICU stay. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Table 24: Comparison of all treatment pairs related to outcome ICU stay. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic	Open
Robotic	Robotic	-1.48 [-3.35; 0.39]	-3.99 [-6.30; -1.67]
Laparoscopic	-1.74 [-3.52; 0.04]	Laparoscopic	-2.50 [-3.95; -1.04]
Open	-4.01 [-5.97; -2.05]	-2.27 [-3.71; -0.83]	Open

Supplementary Table 25: Assessment of inconsistency for all studies related to outcome ICU stay.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	8	-2.26988419156948	-2.49779691981468	13.8811562712979	-16.3789531911125	-28.6966639155707	-4.0612424666544	0.009155861363346
2	Laparoscopic:Robotic	4	1.7374978919991	1.47524835850292	4.27367574928185	-2.79842739077892	-8.9071835480017	3.31032876644386	0.36925939817614
3	Robotic:Open	3	-4.00738208356858	-3.9864497135483	-4.06072048216327	0.0742707686149764	-4.28311480244657	4.43165633967653	0.973349871697191

Supplementary Figure 88: Summary Forrest Plot for outcome ICU stay. Ranking of the interventions based on the SUCRA value.

Reintervention rate

Supplementary Figure 89: Network plot of all studies for outcome reintervention rate. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 90: Bayesian random effect consistency model forrest plot for outcome reintervention rate.

Supplementary Table 26: Treatment effects for all studies: comparison of all treatment pairs. Outcomes reinterention rate. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	1.79 (1.04, 3.1)	0.81 (0.47, 1.3)
Open	0.56 (0.32, 0.96)	Open	0.45 (0.23, 0.84)
Robotic	1.24 (0.77, 2.13)	2.22 (1.2, 4.44)	Robotic

Supplementary Figure 91: Litmus Rank-O-Gram: Outcomes reintervention rate. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 92: Radial SUCRA plot: Outcomes reintervention rate. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 93: Nodesplit model for the outcome reintervention rate.

Supplementary Figure 94: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 95: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 96: Leverage plot for all studies.

Hospital stay

Supplementary Figure 97: Individual study results grouped by treatment comparison for the outcome hospital stay.

Supplementary Figure 98: Network plot of all studies for outcome hospital stay. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 99: Forest plot for outcome hospital stay. Between-study standard deviation: 2.07 , Number of studies: 63 , Number of treatments: 3. All outcomes are versus the reference treatment: Open.

Supplementary Table 27: Comparison of all treatment pairs related to outcome hospital stay. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.

Robotic	Laparoscopic	Open
Robotic	Robotic	-1.67 [-2.42; -0.92]	-5.71 [-7.26; -4.15]
Laparoscopic	-1.16 [-1.88; -0.44]	Laparoscopic	-6.43 [-7.35; -5.52]
Open	-7.63 [-8.65; -6.61]	-6.47 [-7.33; -5.60]	Open

Supplementary Table 28: Assessment of inconsistency for all studies related to outcome hospital stay.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	32	-6.46515733262787	-6.43297469604174	-6.73315521005415	0.300180514012414	-2.50144720924287	3.1018082372677	0.83366734585659
2	Laparoscopic:Robotic	39	1.16333827634672	1.66867995769393	-5.32895898481172	6.99763894250565	4.21241981649106	9.78285806852023	8.46837349508198e-07
3	Robotic:Open	10	-7.62849560897459	-5.70567513075511	-9.05911443783396	3.35343930707885	1.29546484318225	5.41141377097545	0.00140446112270975

Supplementary Figure 100: Summary Forrest Plot for outcome hospital stay. Ranking of the interventions based on the SUCRA value.

Supplementary Figure 101: Bayesian random effect consistency model forrest plot for outcome hospital stay. Between-study standard deviation: 10.86 . 95% credible interval: 9.14 , 12.96 .

Supplementary Table 29: Treatment effects for all studies: comparison of all treatment pairs. Outcomes hospital stay. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	6.93 (3.23, 10.67)	-1.83 (-5.17, 1.55)
Open	-6.93 (-10.67, -3.23)	Open	-8.77 (-13.34, -4.22)
Robotic	1.83 (-1.55, 5.17)	8.77 (4.22, 13.34)	Robotic

Supplementary Figure 102: Litmus Rank-O-Gram: Outcomes hospital stay. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 103: Radial SUCRA plot: Outcomes hospital stay. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 104: Nodesplit model for the outcome hospital stay.

Supplementary Figure 105: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 106: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 107: Leverage plot for all studies.

Supplementary Figure 108: Regression plot for the outcome hospital stay having as covariate the year of study publication.

Supplementary Figure 109: Regression plot for the outcome hospital stay having as covariate the number of patients in the inlcuded studies.

Readmission rate

Supplementary Figure 110: Individual study results grouped by treatment comparison for the outcome readmission rate.

Supplementary Figure 111: Network plot of all studies for outcome readmission rate. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 112: Forest plot for outcome readmission rate. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively. Between-study standard deviation (log-odds scale): 0.22 , Number of studies: 29 , Number of treatments: 3.

Supplementary Table 30: Comparison of all treatment pairs related to outcome readmission rate. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies.

Laparoscopic	Robotic	Open
Laparoscopic	Laparoscopic	0.86 [0.71; 1.05]	0.80 [0.58; 1.11]
Robotic	0.86 [0.71; 1.04]	Robotic	0.96 [0.61; 1.52]
Open	0.80 [0.59; 1.09]	0.93 [0.67; 1.30]	Open

Supplementary Table 31: Assessment of inconsistency for all studies related to outcome readmission rate.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	9	-0.218360537403712	-0.222631724157136	-0.18697809697847	-0.0356536271786658	-0.981578509784171	0.910271255426839	0.941110164471328
2	Laparoscopic:Robotic	22	-0.150562599201622	-0.148463744313914	-0.241225097414418	0.0927613531005043	-1.20710767447626	1.39263038067727	0.888764996137389
3	Robotic:Open	2	-0.06779793820209	-0.0406989660645829	-0.0976042007983429	0.0569052347337601	-0.60711274694509	0.72092321641261	0.866610303969005

Supplementary Figure 113: Summary Forrest Plot for outcome readmission rate. Ranking of the interventions based on the SUCRA value.

In-hospital mortality

Supplementary Figure 114: Individual study results grouped by treatment comparison for the outcome in-hospital mortality.

Supplementary Figure 115: Network plot of all studies for outcome in-hospital mortality. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 116: Forest plot for outcome in-hospital mortality. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 117: Bayesian random effect consistency model forrest plot for outcome in-hospital mortality.

Supplementary Figure 118: Litmus Rank-O-Gram: Outcomes in-hospital mortality. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 119: Radial SUCRA plot: Outcomes in-hospital mortality. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 120: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 121: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 122: Leverage plot for all studies.

Supplementary Figure 123: Regression plot for the outcome in-hospital mortality having as covariate the year of study publication.

Supplementary Figure 124: Regression plot for the outcome in-hospital mortality having as covariate the number of patients in included studies.

30-day mortality

Supplementary Figure 125: Individual study results grouped by treatment comparison for the outcome 30-day mortality.

Supplementary Figure 126: Network plot of all studies for outcome 30-day mortality. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 127: Forest plot for outcome 30-day mortality. With red – prediction intervals.

Supplementary Figure 128: P-scores Heatmap for the outcome 30-day mortality.

Supplementary Figure 129: Forest plot for outcome 30-day mortality. Between-study standard deviation (log-odds scale): 0 , Number of studies: 20 , Number of treatments: 3. All outcomes are versus the reference treatment: Open.

Supplementary Table 32: Comparison of all treatment pairs related to outcome 30-day mortality. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic	Open
Robotic	Robotic	0.52 [0.26; 1.05]	0.18 [0.04; 0.80]
Laparoscopic	0.54 [0.27; 1.07]	Laparoscopic	0.73 [0.42; 1.26]
Open	0.37 [0.16; 0.84]	0.68 [0.40; 1.17]	Open

Supplementary Table 33: CINEMA league table.

Laparoscopic	0.702 (0.416, 1.182)	1.474 (0.794, 2.735)
1.425 (0.846, 2.401)	Open	2.101 (0.970, 4.552)
0.678 (0.366, 1.259)	0.476 (0.220, 1.031)	Robotic

Supplementary Table 34: Assessment of inconsistency for all studies related to outcome 30-day mortality.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	14	-0.378520290715878	-0.310717066049767	-2.21943298061361	1.90871591456384	-0.98696979565642	4.8044016247841	0.196382438706105
2	Laparoscopic:Robotic	9	0.621631160660939	0.646693519227774	-2.12870619665136	2.77539971587913	-4.51648257074522	10.0672820025035	0.455672443607904
3	Robotic:Open	3	-1.00015145137682	-1.70817230331255	-0.681081261909629	-1.02709104140292	-2.82067903886081	0.766496956054965	0.261707029012972

Supplementary Figure 130: Summary Forrest Plot for outcome 30-day mortality. Ranking of the interventions based on the SUCRA value.

Supplementary Figure 131: Nodesplit model for the outcome 30-day mortality.

Supplementary Figure 132: evaluation of inconsistency in CINEMA.

Supplementary Figure 133: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 134: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 135: Leverage plot for all studies.

Supplementary Figure 136: Regression plot for the outcome 30-day mortality having as covariate the year of study publication.

Supplementary Figure 137: Forrest plot of metaregression for the outcome 30-day mortality having as covariate the year of the study publication.

Supplementary Figure 138: Regression plot for the outcome 30-day mortality having as covariate the number of patients in the included studies.

Supplementary Figure 139: Forrest plot of metaregression for the outcome 30-day mortality having as covariate the number of patiemts in theincluded studies.

Supplementary Figure 140: Publication bias evaluation for the outcomes 30-day mortality.

90-day major complications

Supplementary Figure 141: Individual study results grouped by treatment comparison for the outcome 90-day major complications.

Supplementary Figure 142: Network plot of all studies for outcome 90-day major complications. The size of the nodes and thickness of edges represent the number of studies that examined a treatment and compared two given treatments respectively.

Supplementary Figure 143: Forest plot for outcome 90-day major complications. Between-study standard deviation (log-odds scale): 0.25 , Number of studies: 3 , Number of treatments: 3. All outcomes are versus the reference treatment: Open

Supplementary Table 35: Comparison of all treatment pairs related to outcome 90-day major complication. Treatments are ranked from best to worst along the leading diagonal. Above the leading diagonal are estimates from pairwise meta-analyses, below the leading diagonal are estimates from network meta-analyses. Relative treatment effects in ranked order for all studies

Robotic	Laparoscopic	Open
Robotic	Robotic	1.03 [0.59; 1.80]	0.71 [0.30; 1.69]
Laparoscopic	0.98 [0.56; 1.71]	Laparoscopic	0.91 [0.51; 1.63]
Open	0.86 [0.44; 1.68]	0.88 [0.51; 1.52]	Open

Supplementary Table 36: Assessment of inconsistency for all studies related to outcome 90-day major complications.

Comparison	No.Studies	NMA	Direct	Indirect	Difference	Diff_95CI_lower	Diff_95CI_upper	pValue
1	Laparoscopic:Open	2	-0.132279178331727	-0.0928277945166356	-0.480843755083479	0.388015960566844	-1.43013923065722	2.20617115179091	0.675742670072934
2	Laparoscopic:Robotic	2	0.0198914668006144	-0.0263735095479554	3.90314518729222	-3.92951869684018	-9.08671399413491	1.22767660045456	0.135334559018435
3	Robotic:Open	1	-0.152170645132341	-0.336347244433062	0.131663944262061	-0.468011188695123	-1.84425599545742	0.908233618067173	0.50508324817545

Supplementary Figure 144: Summary Forrest Plot for outcome 90-day major complications. Ranking of the interventions based on the SUCRA value.

Supplementary Figure 145: Bayesian random effect consistency model forrest plot for outcome 90-day major complications. Between-study standard deviation (log-odds scale): 0.37 . 95% credible interval: 0.02 , 0.78 .

Supplementary Table 37: Treatment effects for all studies: comparison of all treatment pairs. Outcomes 90-day major complications. Bayesian NMA.

Laparoscopic	Open	Robotic
Laparoscopic	Laparoscopic	1.12 (0.43, 2.2)	0.97 (0.42, 1.99)
Open	0.9 (0.45, 2.3)	Open	0.87 (0.36, 2.42)
Robotic	1.03 (0.5, 2.36)	1.15 (0.41, 2.75)	Robotic

Supplementary Figure 146: Litmus Rank-O-Gram: Outcomes 90-day major complications. Higher SUCRA (Surface Under the Cumulative Ranking Curve) values and cumulative ranking curves nearer the top left indicate better performance.

Supplementary Figure 147: Radial SUCRA plot: Outcomes 90-day major complications. Higher SUCRA values indicate better treatments; size of nodes represent number of participants and thickness of lines indicate number of trials conducted.

Supplementary Figure 148: Nodesplit model for the outcome 90-day major complications.

Supplementary Figure 149: Residual deviance from NMA model and UME inconsistency model for all studies.

Supplementary Figure 150: Per-arm residual deviance for all studies. This stem plot represents the posterior residual deviance per study arm.

Supplementary Figure 151: Leverage plot for all studies.

Supplementary Figure 152: Regression plot for the outcome 90-day major complications having as covariate the year of study publication.