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Updated: Jan 13, 2026
Robot-Assisted Radical Antegrade Modular Pancreatosplenectomy Including Resection and Reconstruction of the Spleno-Mesenteric Junction
Published on: January 3, 2020
Robotic Adrenalectomy Is Associated With Shortened Hospital Stay and in Large Tumors (≥ 6 cm) May Reduce
Noa Grunberg1, Nicolas Michot2, David Dussard1
1Department of Digestive and Endocrine Surgery, University Hospital of Orleans, Orléans, France.
Background:
Robotic adrenalectomy (RA) is increasingly adopted, but its clinical value compared with laparoscopic adrenalectomy (LA) remains unclear. We assessed perioperative outcomes and the learning curve of RA.
Methods:
A bicentric retrospective study included 228 patients who underwent adrenalectomy between 2013 and 2023 (97 RA, 131 LA). Primary outcomes were intra- and postoperative complications (Clavien-Dindo, Comprehensive Complication Index, CCI). Secondary outcomes included operative time and length of stay (LOS). Subgroup analysis evaluated tumors ≥ 6 cm. RA learning curve was assessed with cumulative sum (CUSUM) analysis.
Results:
Patients in the RA group had higher ASA scores, more prior abdominal surgery, and larger tumors. Overall complication rates were similar (RA 18.6% vs. LA 17.6%, p = 0.846). RA was independently associated with shorter LOS (OR 0.48; 95% CI 0.26-0.84; p = 0.012). In tumors ≥ 6 cm, RA reduced postoperative complications (5.3% vs. 35.3%, p = 0.037). CUSUM analysis showed earlier improvements in operative time (after 25 cases) and later reductions in morbidity (after ∼ 45 cases).
Conclusions:
RA is a safe alternative to LA even in complex patients. It shortens LOS overall and improves outcomes in large adrenal tumors. CUSUM analysis highlights a progressive but safe learning curve, supporting the integration of RA into endocrine surgical practice.
