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Robot-assisted laparoscopic adrenalectomy: Extended application in children
Kiarash Taghavi1, Mathilde Glenisson2, Klervie Loiselet3
1Department of Pediatric Surgery and Urology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; Departments of Paediatric Urology, Monash Children Hospital, Melbourne, Victoria, Australia; Departments of Paediatrics, Monash University, Melbourne, Victoria, Australia. Electronic address: https://twitter.com/kiarash_taghavi.
Robot-assisted laparoscopic adrenalectomy (RALA) is safe and effective for children with adrenal tumours, including high-risk neuroblastomas and endocrine tumours. This study shows RALA offers significant benefits in paediatric oncology and endocrinology care.
Area of Science:
- Paediatric surgery
- Surgical oncology
- Robotic surgery
Background:
- Minimally invasive surgery for paediatric adrenal tumours is evolving.
- Robot-assisted laparoscopic adrenalectomy (RALA) in children is understudied.
- This study evaluates RALA's safety and efficacy in paediatric adrenal tumour treatment.
Purpose of the Study:
- To demonstrate the safety and efficacy of RALA in treating children with adrenal tumours.
- To analyze outcomes of RALA for neuroblastic and endocrine adrenal tumours in children.
Main Methods:
- Prospective institutional analysis of children with adrenal tumours treated with RALA over six years.
- Collection of clinical parameters including diagnosis, surgical details, and outcomes.
- Analysis of 50 RALA procedures for neuroblastic and endocrine tumours.
Main Results:
- 50 RALA procedures performed: 23 for neuroblastic tumours (87% neuroblastomas) and 27 for endocrine tumours.
- Macroscopically clear resection margins achieved in all cases; median length of stay was two days.
- Low complication rate (1 Grade IIIb) and conversion rate (1 non-emergent) with favorable outcomes for endocrine tumours; high-risk neuroblastomas showed variable outcomes.
Conclusions:
- RALA is safe and effective in carefully selected children with adrenal tumours.
- Indications for RALA have been clarified and extended in a dedicated paediatric robotic surgical team setting.
- RALA is particularly useful for paediatric patients with severe disease (IDRF+ metastatic neuroblastomas) or genetic predisposition syndromes.
