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Laparoscopic versus robotic adrenalectomy: A comprehensive meta-analysis.

Konstantinos P Economopoulos¹, Konstantinos S Mylonas², Aliki A Stamou³

¹Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Society of Junior Doctors, Athens, Greece.

International Journal of Surgery (London, England)

|January 4, 2017

Summary

Robotic adrenalectomy (RA) and laparoscopic adrenalectomy (LA) show similar clinical outcomes, with RA offering a shorter hospital stay but longer operating times. Further research is needed to define RA's role and cost-effectiveness.

Keywords:

Laparoscopic adrenalectomy Meta-analysis Robot-assisted adrenalectomy Robotic adrenalectomy

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Area of Science:

Minimally Invasive Surgery
Surgical Oncology
Robotic Surgery

Background:

The comparative benefits of robotic adrenalectomy (RA) versus laparoscopic adrenalectomy (LA) remain under investigation.
Existing evidence is synthesized to assess which procedure yields superior clinical outcomes.

Purpose of the Study:

To systematically review and synthesize available evidence comparing robotic adrenalectomy (RA) to laparoscopic adrenalectomy (LA).
To evaluate the clinical outcomes of RA versus LA in adrenal surgery.

Main Methods:

A systematic literature search was conducted on PubMed and Scopus databases, adhering to PRISMA guidelines.
Data from 27 studies (13 comparative, 14 non-comparative) involving 1162 patients were extracted by three independent reviewers.
Perioperative variables were pooled using a random-effects model.

Main Results:

No significant differences were observed between RA and LA for intraoperative and postoperative complications, mortality, or blood loss.
Robotic adrenalectomy was associated with a significantly shorter hospital stay (WMD: -0.40 days).
Operating time was significantly longer for robotic adrenalectomy (WMD: 15.60 minutes).

Conclusions:

Robotic adrenalectomy is a safe and feasible alternative to laparoscopic adrenalectomy for selected patients.
Clinical outcomes are comparable between the two surgical approaches.
High-quality randomized controlled trials and standardized outcome reporting are necessary to establish the definitive role and cost-effectiveness of robotic adrenal surgery.