Evidence-Based Surgical Practice: A Systematic Review of Contemporary Approaches to Common General Surgical Procedures

Abstract

The landscape of general surgery has undertaken transformative changes over the past two decades, determined by technological innovation, evidence-based practice frameworks, and the widespread adoption of minimally invasive techniques. This systematic review synthesizes contemporary evidence on surgical approaches to the most frequently performed general surgical measures. Though, a detailed literature search was made using the Cochrane Library, Scopus, PubMed, and Web of Science (WoS) databases, comprising findings published from January 2020 to June 2026. Studies were designated according to predefined inclusion criteria, with primary emphasis placed on randomized controlled trials (RCTs), systematic reviews, and meta-analyses. The PRISMA 2020 strategies were tracked throughout. Moreover, laparoscopic surgery remains the evidence-based standard of care for cholecystectomy and appendectomy (Grade A recommendation). For inguinal hernia repair, laparoscopic methods demonstrate superiority in wound infection reduction and shorter hospital stays, though open repair with local anesthesia remains a viable alternative in selected patients. In colorectal cancer surgery, robotic-assisted surgery shows significant advantages in conversion rates and circumferential resection margin status compared to conventional laparoscopy. Notably, open radical hysterectomy remains superior to minimally invasive approaches for early-stage cervical cancer based on landmark RCT evidence. Furthermore, Evidence-based surgical practice demands individualized approach selection based on procedure-specific evidence, patient factors, surgeon expertise, and institutional resources. While minimally invasive techniques dominate most common procedures, open surgery retains critical indications in oncology, trauma, and complex cases.