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Single-port robot-assisted adrenalectomy: technical considerations and a single-center experience
Marwan Alkassis1, Lorenzo Santodirocco2, Jin-Chun Qi3
1Department of Urology, University of Illinois Chicago, Chicago, IL, USA.
Summary
Single-port robot-assisted adrenalectomy (SP-RA) is a safe and feasible surgical technique. This approach, often utilizing a retroperitoneal route, allows for minimal blood loss and short hospital stays, facilitating outpatient management.
Area of Science:
- Minimally Invasive Surgery
- Robotic Surgery
- Surgical Oncology
Background:
- Adrenalectomy is a common surgical procedure for adrenal gland pathologies.
- Advancements in robotic surgery offer potential benefits for adrenalectomy.
- Single-port surgery aims to reduce invasiveness and improve cosmetic outcomes.
Purpose of the Study:
- To describe the surgical technique for single-port robot-assisted adrenalectomy (SP-RA).
- To report initial clinical experience and outcomes of SP-RA.
- To evaluate the technical feasibility and considerations of SP-RA.
Main Methods:
- Retrospective review of patients undergoing SP-RA (January 2021 - January 2026).
- Procedures performed using the da Vinci SP® system, transitioning from transperitoneal to retroperitoneal approach.
- Analysis of demographic, operative, and postoperative outcomes; operative time assessed with Spearman's correlation.
Main Results:
- Twenty-three patients underwent SP-RA, with a majority having functioning tumors.
- The retroperitoneal approach was predominantly used (82.6%).
- Median operative time was 154 minutes with minimal blood loss (20 mL). High rates of same-day discharge (52.2%) and low complication rates were observed.
Conclusions:
- Single-port robot-assisted adrenalectomy (SP-RA) using a supine anterior retroperitoneal approach is safe and feasible.
- The technique is associated with minimal blood loss and short hospitalization periods.
- SP-RA frequently enables outpatient management, demonstrating its efficiency.
