title: Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial.
abstract: BACKGROUND
  The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for disorders of the adrenal gland in terms of feasibility, safety, and length of hospitalization.
  
  
  METHODS
  Twenty consecutive patients with benign lesions of adrenal gland were randomized into two groups: Patients in the laparoscopic group underwent traditional laparoscopic adrenalectomy (LAP), whereas those in the robotic group underwent robot-assisted adrenalectomy (ROBOT) using the da Vinci robotic system.
  
  
  RESULTS
  There was no significant difference between the groups in terms of age, sex, body mass index, and size or locations of lesions. Operative times were significant longer in the ROBOT group (total operative time, 169.2 min [range, 136-215] vs 115.3 min (range, 95-155) p < 0.001. Skin-to-skin time was 107 m (range, 77-154) vs 82.1 min (range, 55-120) (p < 0.001). There were no conversions to open surgery. However, conversion to standard laparoscopic surgery was necessary in four of 10 ROBOT patients (40%; left, one right). Perioperative morbidity was higher in the ROBOT group (20% vs 0%). There was no difference in length of hospital stay. In the following ROBOT group, hospital stay was 5.7 days (range, 4-9) vs 5.4 days (range, 4-8) in the LAP group (p = NS). The total cost of the ROBOT procedure ($3,467) was significantly higher than that for LAP ($2,737) (p < 0.01).
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy is superior to robot-assisted adrenalectomy in terms of feasibility, morbidity, and cost.
authors.affiliation: Department of Surgery, Minimally Invasive Surgery Center, University of Turin, C/O A.M. Dogliotti 14, Turin, 10126, Italy. mario.morino@unito.it
authors.forename: M
authors.initials: M
authors.lastname: Morino
authors.forename: G
authors.initials: G
authors.lastname: Benincà
authors.forename: G
authors.initials: G
authors.lastname: Giraudo
authors.forename: G M
authors.initials: GM
authors.lastname: Del Genio
authors.forename: F
authors.initials: F
authors.lastname: Rebecchi
authors.forename: C
authors.initials: C
authors.lastname: Garrone
mesh_terms: D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012371:Robotics