Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?

Brunaud, Laurent; Bresler, Laurent; Ayav, Ahmet; Zarnegar, Rasa; Raphoz, Anne-Laure; Levan, Than; Weryha, Georges; Boissel, Patrick

doi:10.1016/j.amjsurg.2007.04.016

« Previous Next »The American Journal of Surgery
Volume 195, Issue 4 , Pages 433-438, April 2008

Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?

Presented at the Annual Meeting of the American Association of Endocrine Surgeons (poster), New York, NY, USA, May 7–9, 2006

Laurent Brunaud, M.D., Ph.D.
- Department of General and Endocrine Surgery, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, 11 allee du morvan, 54511 Vandoeuvre les Nancy, France
- Corresponding author. Tel.: +33-383153120; fax: +33-383153121.
Laurent Bresler, M.D., Ph.D.
- Department of General and Endocrine Surgery, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, 11 allee du morvan, 54511 Vandoeuvre les Nancy, France
Ahmet Ayav, M.D., Ph.D.
- Department of General and Endocrine Surgery, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, 11 allee du morvan, 54511 Vandoeuvre les Nancy, France
Rasa Zarnegar, M.D., Ph.D.
- Department of Surgery Weill Cornell Medical College, New York, NY
Anne-Laure Raphoz, M.D.
- Department of General and Endocrine Surgery, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, 11 allee du morvan, 54511 Vandoeuvre les Nancy, France
Than Levan, M.D.
- Department of General and Endocrine Surgery, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, 11 allee du morvan, 54511 Vandoeuvre les Nancy, France
Georges Weryha, M.D., Ph.D.
- Department of Endocrinology, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, Vandoeuvre les Nancy, France
Patrick Boissel, M.D., Ph.D.
- Department of General and Endocrine Surgery, CHU Nancy (Hopital Brabois Adultes), University of Nancy, School of Medicine, 11 allee du morvan, 54511 Vandoeuvre les Nancy, France

Received 6 October 2006; received in revised form 18 April 2007 published online 28 February 2008.

Abstract

Background

This study evaluates the perioperative outcomes of robotic-assisted adrenalectomy (RA) compared with lateral transperitoneal laparoscopic adrenalectomy (LA).

Methods

Prospective evaluation of 50 patients who underwent unilateral RA versus 59 patients who underwent unilateral LA.

Results

RA was associated with lower blood loss (49 mL) but longer operative times (104 minutes) (P <.001). However, the difference in operative time was not significant after the learning curve of 20 cases. In patients with body mass index (BMI) ≥30 kg/m², mean operative time was longer in the LA group (90 vs 78 minutes, P = .03) but not in the RA group. In patients with large tumors (≥55 mm), mean operative time was longer in the LA group (100 vs 80 minutes, P = .009) but not in the RA group. Conversion rate, morbidity, and hospital stay were similar in both groups.

Conclusions

After a learning curve of 20 cases, RA has similar perioperative outcomes compared to lateral transperitoneal LA. Several criteria (previous laparoscopic expertise, first assistant’s skill and tumor side) remain determinative on RA operative time.

Keywords: Robotics, Adrenalectomy, Adrenal glands, Pheochromocytoma, Telerobotics, Laparoscopy