Related Experiment Video
Updated: May 10, 2025
Laparoscopic Posterior Radical Antegrade Modular Pancreatosplenectomy for Distal Pancreatic Carcinoma
Published on: December 29, 2023
Treatment Outcomes of Robotic Adrenalectomy Compared to Laparoscopic Adrenalectomy: A Propensity Score Matching Study
Miki Naito1, Hiroyuki Shikuma1, Tomoya Hatayama1
1Department of Urology, Hiroshima University, Hiroshima, Japan.
Introduction:
Laparoscopic adrenalectomy is a common procedure for the treatment of adrenal tumors. However, the recent inclusion of robotic adrenalectomy in the list of insurance-covered procedures in Japan since April 2022 has raised questions regarding its broader clinical utility. This study aimed to elucidate the treatment outcomes of robotic adrenalectomy and conduct a comprehensive analysis comparing laparoscopic and robotic adrenalectomies.
Methods:
The baseline characteristics of patients and perioperative outcomes between laparoscopic and robotic adrenalectomies performed at Hiroshima University in July 2022 using the da Vinci Si, da Vinci Xi, and Hinotori were compared. Propensity score matching was performed to compare the outcomes of laparoscopic and robotic adrenalectomies.
Results:
Laparoscopic and robotic adrenalectomies were performed in 292 and 43 patients, respectively. There were no statistically significant differences between equipment. In the baseline characteristics of patients, the body mass index of the laparoscopic adrenalectomy group was smaller than that of the robotic adrenalectomy group. As for perioperative outcomes, the length of stay and number of complications were less for robotic adrenalectomy than for laparoscopic adrenalectomy. After matching for the body mass index, robotic adrenalectomy showed less bleeding and fewer intraoperative complications than laparoscopic adrenalectomy. However, after matching for general factors, patients with robotic adrenalectomy had shorter hospital stays and fewer intraoperative complications.
Conclusions:
Compared with laparoscopic adrenalectomy, robotic adrenalectomy can be performed safely with fewer intraoperative complications and may also have shorter hospital stays and minimal bleeding.
Insights
Robotic adrenalectomy offers a safe alternative to laparoscopic procedures, demonstrating fewer complications and shorter hospital stays. This minimally invasive approach shows promise for improved patient outcomes in adrenal tumor treatment.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Urology
Background:
- Laparoscopic adrenalectomy is a standard treatment for adrenal tumors.
- Robotic adrenalectomy is now covered by insurance in Japan, prompting evaluation of its clinical utility.
- Adrenal tumor treatment outcomes require updated comparative analyses.
Purpose of the Study:
- To evaluate treatment outcomes of robotic adrenalectomy.
- To compare robotic and laparoscopic adrenalectomy outcomes comprehensively.
- To assess the safety and efficacy of robotic adrenalectomy in clinical practice.
Main Methods:
- Comparative analysis of laparoscopic and robotic adrenalectomies at Hiroshima University.
- Utilized da Vinci Si, da Vinci Xi, and Hinotori robotic systems.
- Propensity score matching applied to compare patient cohorts and perioperative outcomes.
Main Results:
- 43 robotic and 292 laparoscopic adrenalectomies were performed.
- Robotic adrenalectomy showed reduced length of stay and fewer complications.
- Matched analysis revealed less bleeding and fewer intraoperative complications with robotic approach.
Conclusions:
- Robotic adrenalectomy is a safe procedure compared to laparoscopic adrenalectomy.
- Robotic approach may lead to shorter hospital stays and reduced bleeding.
- Fewer intraoperative complications are associated with robotic adrenalectomy.
