Laparoscopic versus robotic lateral transabdominal adrenalectomy

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Robotic adrenalectomy adoption is increasing, but its benefits compared to laparoscopic adrenalectomy (LA) remain unclear.
• A large single-center experience is utilized to compare these two surgical approaches.

Purpose of the Study:

• To compare perioperative outcomes between robotic and laparoscopic lateral transabdominal adrenalectomy.
• To evaluate the efficacy and safety of robotic versus LA.

Main Methods:

• Retrospective analysis of a 22-year institutional review board-approved database.
• Comparison of clinical and perioperative outcomes between 190 laparoscopic and 281 robotic adrenalectomy patients.
• Statistical analysis using Mann-Whitney U and chi-squared tests.

Main Results:

• Robotic adrenalectomy demonstrated shorter operative times and hospital stays compared to LA.
• Less blood loss, fewer conversions to open surgery, and improved margin positivity were observed with the robotic approach, particularly for pheochromocytoma and malignant tumors.
• Similar morbidity rates were reported between the robotic and laparoscopic groups.

Conclusions:

• Robotic transabdominal lateral adrenalectomy offers significant advantages over LA regarding perioperative outcomes.
• Improved margin clearance is a key benefit of the robotic approach.
• Despite retrospective design limitations, findings support robotic adrenalectomy's efficacy.