title: Robotic versus laparoscopic adrenalectomy for pheochromocytoma.
abstract: BACKGROUND
  Although initial reports demonstrated the safety and feasibility of robotic adrenalectomy (RA), there are scant data on the use of this approach for pheochromocytoma. The aim of this study is to compare perioperative outcomes and efficacy of RA versus laparoscopic adrenalectomy (LA) for pheochromocytoma.
  
  
  METHODS
  Within 3 years, 25 patients underwent 26 RA procedures for pheochromocytoma. These patients were compared with 40 patients who underwent 42 LA procedures before the start of the robotic program. Data were retrospectively reviewed from a prospectively maintained, IRB-approved adrenal database.
  
  
  RESULTS
  Demographic and clinical parameters at presentation were similar between the groups, except for a larger tumor size in the robotic group. In both groups, skin-to-skin operative time, estimated blood loss less, and intraoperative hemodynamic parameters were similar. The conversion to open rate was 3.9 % in the robotic and 7.5 % in the laparoscopic group (p = .532). There was no morbidity or mortality in the robotic group; morbidity was 10 % (p = .041) and mortality 2.5 % in the laparoscopic group. The pain score on postoperative day 1 was lower, and the length of hospital stay shorter in the robotic group (1.2 ± .1 vs. 1.7 ± .1 days, p = .036).
  
  
  CONCLUSIONS
  To our knowledge, this is the first study comparing robotic versus laparoscopic resection of pheochromocytoma. Our results show that the robotic approach is similar to the laparoscopic regarding safety and efficacy. The lower morbidity, less immediate postoperative pain, and shorter hospital stay observed in the robotic approach warrant further investigation in future larger studies.
authors.affiliation: Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Shamil
authors.initials: S
authors.lastname: Aliyev
authors.forename: Koray
authors.initials: K
authors.lastname: Karabulut
authors.forename: Orhan
authors.initials: O
authors.lastname: Agcaoglu
authors.forename: Katherine
authors.initials: K
authors.lastname: Wolf
authors.forename: Jamie
authors.initials: J
authors.lastname: Mitchell
authors.forename: Allan
authors.initials: A
authors.lastname: Siperstein
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010673:Pheochromocytoma / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012371:Robotics