A prospective study of 100 roboticallyassisted laparoscopic adrenalectomies

We evaluated robotically assisted laparoscopic adrenalectomy (RLA) in a prospective study of 100 consecutive patients (60 women and 40 men) undergoing unilateral adrenalectomy at the University Hospital. The median age was 59 (24-82) years and BMI 27.6 (17.1-40.9) kg/m(2). Preoperative diagnoses were Conn's syndrome 30%, pheochromocytoma 23%, Cushing syndrome 27% and non-functional tumor 20%. The median tumor size was 53 (10-106) mm. The majority of the 7% of the patients who were converted to open surgery were in the early phase after the introduction of the technique. The BMI of the patients who were converted to open surgery was significantly higher, 31.5 (range 25.3-37.8) compared to, 27.5 (range 17.1-40.9) in patients without conversion (P = 0.047). The median weight of the tumor was 51 g for patients with conversion (range 18-97 g) and 30 g (range 8-128 g) for patients without conversion (P = 0.066). The median console operation time for the whole series was 88 min (range 39-397 min). The console operation time decreased significantly with the numbers of patients operated (r = 0.372; P = 0.0003). There was an association between the weight of the specimen and operation time (r = 0.42; P = 0.0001). RLA is a safe and a feasible surgical alternative for treating all kind of adrenal disorders, particularly large tumors and more complex circumstances. The present study clearly shows that a learning curve is present for the console surgeon and assistants.