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Robotic-Assisted Versus Laparoscopic Adrenalectomy: Outcome Comparison from a Single-Center Experience.
Tamar Tsenteradze1, Agustina A Pontecorvo1, Horacio J Asbun1
1Division of Advanced Gastrointestinal and Bariatric Surgery, Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|December 30, 2025
Summary
Robotic-assisted laparoscopic adrenalectomy (RALA) offers shorter operative times, reduced hospital stays, and fewer early complications compared to traditional laparoscopic adrenalectomy (LA). Further randomized trials are needed to confirm these benefits for adrenal lesion treatment.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Robotic Surgery
Background:
- Robotic-assisted laparoscopic adrenalectomy (RALA) is an emerging technique for adrenal lesion treatment.
- Laparoscopic adrenalectomy (LA) is the established minimally invasive approach.
- Comparative studies are essential to define RALA's advantages over LA.
Purpose of the Study:
- To compare perioperative and postoperative outcomes between RALA and LA.
- To identify specific scenarios where RALA may provide superior results.
- To evaluate the efficacy of RALA for adrenalectomy.
Main Methods:
- Retrospective study of 321 patients undergoing adrenalectomy (August 2014 - November 2024).
- 170 patients underwent LA, and 151 patients underwent RALA.
- Comparison of preoperative, perioperative, and postoperative outcomes between the two surgical groups.
Main Results:
- RALA demonstrated significantly shorter operative times (100.5 vs. 117.9 minutes, P=.02).
- Robotic approach resulted in shorter hospital stays (1 vs. 2 days, P<.01) and lower 30-day complication rates (7.3% vs. 14.7%, P=.035).
- No significant differences in estimated blood loss or conversion to open surgery; comparable long-term complications. Subanalysis of large tumors (>5 cm) showed lower early complication rates with RALA (P=.05).
Conclusions:
- RALA offers advantages over traditional LA, including reduced operative time, shorter hospital stay, and fewer early complications.
- The benefits of RALA are particularly noted in early complication rates, even for large adrenal tumors.
- Further randomized controlled trials are recommended to validate these findings and establish definitive conclusions.
