Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?
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) > or = 30 kg/m(2), 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 (> or = 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.
Brunaud
Laurent
L
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. l.brunaud@chu-nancy.fr
Bresler
Laurent
L
Ayav
Ahmet
A
Zarnegar
Rasa
R
Raphoz
Anne-Laure
AL
Levan
Than
T
Weryha
Georges
G
Boissel
Patrick
P
D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology / Q000601:surgery; D000315:Adrenalectomy / Q000295:instrumentation* / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006965:Hyperplasia; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D010673:Pheochromocytoma / Q000601:surgery; D011446:Prospective Studies; D012371:Robotics