Robot-assisted laparoscopic partial adrenalectomy: initial experience.
OBJECTIVE
To evaluate the feasibility of performing robot-assisted laparoscopic partial adrenalectomy (RALPA) in patients seen at the National Cancer Institute and report the results of our initial experience.


METHODS
We reviewed the records of patients with adrenal masses who underwent attempted RALPA from July of 2008 until January of 2010. Demographic, perioperative, and pathologic data were collected. The functional and early oncological outcomes were examined by the need for steroid replacement and development of recurrent disease, respectively.


RESULTS
Ten patients underwent a total of 13 attempted RALPAs for removal of 19 adrenal tumors. There was one open conversion with successful completion of partial adrenalectomy. Of the patients, 80% had a known hereditary syndrome predisposing them to adrenal tumors. One patient had bilateral multifocal adrenal masses with unknown germ line genetic alteration and 1 patient had a sporadic adrenal mass. Of the 19 tumors removed, 17 were pheochromocytoma and 2 were adrenal-cortical hyperplasia. Two patients underwent partial adrenalectomy on a solitary adrenal gland, with one subsequently requiring steroid replacement postoperatively. On postoperative imaging, all but one operated adrenal gland demonstrated contrast enhancement. No patient developed local recurrence at a median follow-up of 16.2 months (range, 2-29).


CONCLUSIONS
RALPA appears safe and feasible in our early experience. Only 1 patient in our series required steroid replacement. Local recurrence rates are low but will require longer follow-up.
Urologic Oncology Branch, National Cancer Institute, Building 10 Room 1-5940, Bethesda, MD 20892-1107, USA.
Ronald S
RS
Boris
Gopal
G
Gupta
W Marston
WM
Linehan
Peter A
PA
Pinto
Gennady
G
Bratslavsky
D000293:Adolescent; D000302:Adrenal Cortex / Q000473:pathology*; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D006965:Hyperplasia; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics; D014057:Tomography, X-Ray Computed; D055815:Young Adult