Robotic single-site adrenalectomy.
Technological advances have brought about robotic single-site (RSS) cholecystectomy and hysterectomy. The application of RSS to additional procedures requires careful assessment of the surgeon learning curve, the technological limitations, patient selection criteria and associated outcomes.



Patient demographics, BMI, surgical indications, adrenal size, OR times, length of stay, postoperative pain and complications were assessed.



Thirty-three patients underwent RSS-A by a single surgeon with 53 % being male, mean age 54 ± 16 years and mean BMI of 32.7. There were 18 left, 10 right, and 5 bilateral procedures for a total of 38 adrenal glands removed (mean tumor size 3.2 cm). There were 5 conversions to a laparoscopic approach, and two to open approach. The necessity for conversion was not associated with age, BMI, tumor size, surgical side or pathology (p > 0.05). The patients who underwent successful unilateral RSS-A had a profile of mean age 55, BMI 31, tumor size 3 cm, and a mean operative time of 118 ± 25.8 min. Pain scores were <4 (10 point scale) in 67 % of patients. 74 % of patients were discharged on POD 1 and 96 % were discharged by POD 2. An assessment of the quartile learning curve for the unilateral RSS-A showed operative times decreased from a mean of 124 to 103 min after 21 cases (p = 0.05).



Patients with functioning and non-functioning tumors, along with those with obesity can safely be treated with RSS-A. The surgeon learning curve was associated with shortened operative times and not increased complication rates.
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Grace S
GS
Lee
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Arman
A
Arghami
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Benzon M
BM
Dy
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Travis J
TJ
McKenzie
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Geoffrey B
GB
Thompson
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Richards.Melanie@mayo.edu.
Melanie L
ML
Richards
D000315:Adrenalectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures
Adrenalectomy; Laparoscopic; Robotic; Single port; Single site