Robotic versus laparoscopic adrenalectomy: a comparative study in a high-volume center

Area of Science:

• Minimally invasive surgery
• Surgical technology
• Urology and general surgery

Background:

• Minimally invasive surgery, including robot-assisted procedures, is increasingly adopted across surgical specialties.
• The da Vinci robot is a key technology driving this trend.
• Objective benefits of robotic surgery over laparoscopy require further evaluation for specific procedures like adrenalectomy.

Purpose of the Study:

• To compare the benefits and drawbacks of robot-assisted laparoscopic adrenalectomy versus standard laparoscopic adrenalectomy.
• To evaluate outcomes in a high-volume surgical center.

Main Methods:

• Retrospective study of 60 patients undergoing adrenalectomy (30 laparoscopic adrenalectomy [LA], 30 robot-assisted adrenalectomy [RA]).
• Comparison of demographic, clinical, histopathological, and surgical variables.
• Statistical analysis using chi-squared and Student's t-tests (p < 0.05 significance).

Main Results:

• No significant demographic differences between groups, though LA had more pheochromocytoma cases (p=0.02).
• Robot-assisted adrenalectomy showed significantly longer operative time (190 ± 33 min vs. 160 ± 41 min, p=0.003).
• A trend towards less blood loss in RA (p=0.07); similar morbidity and hospital stay; no mortality.

Conclusions:

• Robot-assisted adrenalectomy is a safe and feasible alternative to laparoscopic adrenalectomy.
• Surgeons report subjective benefits including 3D visualization and improved ergonomics.
• While operative time is longer, patient outcomes are comparable to the laparoscopic approach.