Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial.

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Endocrinology

Background:

• Adrenal gland disorders require surgical intervention.
• Laparoscopic adrenalectomy (LAP) is a standard minimally invasive approach.
• Robot-assisted adrenalectomy (ROBOT) offers potential benefits but requires evaluation.

Purpose of the Study:

• To compare the feasibility, safety, and hospitalization length of robot-assisted adrenalectomy versus traditional laparoscopic adrenalectomy.
• To assess the benefits and drawbacks of ROBOT surgery for adrenal gland disorders.

Main Methods:

• A randomized study comparing LAP and ROBOT (da Vinci system) for benign adrenal lesions.
• Twenty patients were allocated to either LAP or ROBOT groups.
• Outcomes included operative time, conversion rates, perioperative morbidity, length of stay, and cost.

Main Results:

• ROBOT surgery had significantly longer operative times and skin-to-skin times compared to LAP.
• Conversion to standard laparoscopy was needed in 40% of ROBOT patients; perioperative morbidity was higher in the ROBOT group (20% vs 0%).
• No significant difference in length of hospital stay was observed, but ROBOT procedures were significantly more expensive ($3,467 vs $2,737).

Conclusions:

• Traditional laparoscopic adrenalectomy (LAP) is superior to robot-assisted adrenalectomy (ROBOT) for adrenal gland disorders.
• LAP demonstrates better feasibility, lower morbidity, and reduced costs compared to ROBOT.
• ROBOT-assisted surgery for adrenalectomy is currently less advantageous due to increased operative time, complications, and expense.