Robot-assisted adrenalectomy using a hinotori surgical robot system: Report of first series of six cases

The hinotori surgical robot system, a newly launched platform, has already been utilized in several urological robotic surgeries; however, limited information is available in terms of its feasibility and safety in each type of surgery. The objectives of this study were to describe the perioperative outcomes of the first series of six patients who underwent robot-assisted adrenalectomy (RAA) using hinotori, and compare the outcomes with a similar set of five patients undergoing RAA with the existing system, da Vinci.

This study included a total of 11 consecutive patients with adrenal tumors undergoing RAA between July 2020 and November 2022 at our institution. Comprehensive perioperative outcomes in these patients were retrospectively analyzed.

Median age, body mass index (BMI), and tumor diameter in the hinotori group were 48 years, 27.5 kg/m² , and 36 mm, respectively, and four patients were diagnosed with a functioning tumor, consisting of three and one with hypersecretion of cortisol and catecholamine, respectively. All procedures using hinotori were performed via the transperitoneal approach, and could be completed without conversion to open surgery. Median operative time, time using robotic system, the estimated blood loss, and length of hospital stay in this group were 119 min, 58 min, 8 mL, and 7 days, respectively, and no patient experienced major perioperative complications. There were no significant differences in clinical characteristics between the hinotori and da Vinci groups, and no significant differences in the perioperative outcomes were noted between these two groups.

Despite being a small case series, this is the first study focusing on RAA using the hinotori surgical robot system, which could be efficaciously performed, resulting in the achievement of perioperative findings comparable with those of the da Vinci system.