Laparoscopic Versus Robotic Adrenalectomy: A Randomized Clinical Trial

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Adrenal Gland Surgery

Background:

• Robotic adrenalectomy (RA) shows promise but requires comparison with established laparoscopic adrenalectomy (LA).
• Previous studies on RA vs. LA used outdated technology or focused narrowly on specific patient groups.

Purpose of the Study:

• To compare perioperative outcomes between laparoscopic and robotic transabdominal lateral adrenalectomies.
• To evaluate the impact of surgical approach on operative time, cost, and surgeon ergonomics.

Main Methods:

• A prospective randomized clinical trial involving 54 patients undergoing lateral adrenalectomy.
• Patients were randomized to either laparoscopic adrenalectomy (LA) or robotic adrenalectomy (RA).
• Secondary outcomes included cost and surgeon ergonomics assessed via NASA-TLX and RULA.

Main Results:

• Operative times and perioperative outcomes were similar between LA and RA groups.
• Robotic adrenalectomy (RA) demonstrated significantly lower surgeon workload (NASA-TLX) and improved ergonomic scores (RULA).
• The RA group experienced fewer conversions from the planned minimally invasive approach compared to the LA group.

Conclusions:

• Laparoscopic adrenalectomy (LA) and robotic adrenalectomy (RA) show comparable perioperative outcomes and costs.
• Robotic adrenalectomy (RA) offers superior ergonomics and a reduced rate of conversion to open surgery.
• The findings support RA as a viable alternative for adrenalectomy with enhanced surgeon comfort and procedural reliability.