Comparison of Perioperative Outcomes of Laparoscopic and Single-Port Robotic Adrenalectomy

Background and Objectives: Laparoscopic adrenalectomy is the standard treatment for adrenal tumors, providing reduced postoperative pain, shorter recovery, and improved cosmetic outcomes compared with open surgery. Robotic adrenalectomy was developed to overcome issues resulting from its restricted instrument mobility and two-dimensional vision by providing three-dimensional visualization, tremor elimination, and enhanced dexterity. The single-port (SP) robotic system further reduces invasiveness and improves ergonomics. In this study, we aimed to compare perioperative outcomes between SP robotic and conventional laparoscopic adrenalectomies performed at a single institution. Materials and Methods: This retrospective study included data from 114 consecutive patients who underwent adrenalectomy at Korea University Ansan Hospital between January 2015 and July 2025. Among them, 33 patients underwent robotic adrenalectomy using the da Vinci SP system (SP group), whereas 81 underwent conventional laparoscopic adrenalectomy (laparoscopy group). The preoperative characteristics and perioperative outcomes were compared between the two groups. Results: There were no significant differences in the demographic or tumor characteristics between the groups. Operation time did not differ significantly between the groups; however, in patients undergoing right adrenalectomy, the mean operation time was significantly shorter in the SP group than in the laparoscopy group. Conclusions: SP robotic adrenalectomy demonstrated safety and perioperative outcomes comparable to those of conventional laparoscopic surgery. In right adrenalectomies, the da Vinci SP system achieved a significantly shorter operation time, suggesting that the enhanced instrument flexibility and stable three-dimensional visualization provide a technical advantage in anatomically challenging conditions.