title: Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?
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) > 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.
authors.affiliation: 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
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.forename: Rasa
authors.initials: R
authors.lastname: Zarnegar
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Raphoz
authors.forename: Than
authors.initials: T
authors.lastname: Levan
authors.forename: Georges
authors.initials: G
authors.lastname: Weryha
authors.forename: Patrick
authors.initials: P
authors.lastname: Boissel
mesh_terms: 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