Skip to main content
SpringerLink
Log in

Robotic versus laparoscopic adrenalectomy: a comparative study in a high-volume center

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Minimally invasive surgery has become more popular in recent years. The da Vinci® robot is one of the new technologies the use of which has gained popularity in a host of different specialties. Originally used in cardiac surgery, marked increases in utilization have been seen in urology, gynecology, and thoracic surgery. Use in general surgical procedures has now become more common. The objective benefits of the robot are unclear compared to those of laparoscopy in many procedures. The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for adrenalectomy in a high-volume center compared to routine laparoscopic techniques.

Methods

We conducted a retrospective study including consecutive patients who underwent minimally invasive adrenalectomy in a tertiary referral center at the University of Alabama Birmingham. Demographic, clinical, histopathological, and surgical variables were recorded. Patients were divided in two groups: laparoscopic adrenalectomy (LA) and robot-assisted adrenalectomy (RA). Groups were compared using the χ2 test for categorical variables and Student’s t-test for continuous variables. Significance was considered p < 0.05.

Results

Sixty patients were included, with 30 patients in each group. There were no significant differences between groups with respect to demographic variables except there were more pheochromocytoma patients in the LA group than in the RA group (13/30 vs. 5/30, respectively; p = 0.02). This study demonstrated increased operative time in the robotic group (190 ± 33 min) versus the laparoscopic group (160 ± 41 min) (p = 0.003). There was a trend for less blood loss in RA versus LA (30 ± 5 ml vs. 55 ± 74 ml; p = 0.07). There was no mortality. Morbidity and length of hospital stay were similar for both groups.

Conclusions

Robotic adrenalectomy is as safe and technically feasible as laparoscopic adrenalectomy. Subjective benefits for the surgeon with robot-assisted surgery include three-dimensional operative view, ergonomically comfortable position, and elimination of the surgeon’s tremor. The operating time is significantly longer but patient outcomes are similar to those of the laparoscopic technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gagner M, Lacroix A, Bolte E (1992) Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med 327(14):1033

    Article  PubMed  CAS  Google Scholar 

  2. Schell SR, Talamini MA, Udelsman R (1999) Laparoscopic adrenalectomy for nonmalignant disease: improved safety, morbidity, and cost-effectiveness. Surg Endosc 13(1):30–34

    Article  PubMed  CAS  Google Scholar 

  3. Giulianotti PC, Buchs NC, Addeo P, Bianco FM, Ayloo SM, Caravaglios G, Coratti A (2011) Robot-assisted adrenalectomy: a technical option for the surgeon? Int J Med Robot 7(1):27–32

    Article  PubMed  CAS  Google Scholar 

  4. Heslin MJ, Winzeler AH, Weingarten JO, Diethelm AG, Urist MM, Bland KI (2002) Laparoscopic adrenalectomy and splenectomy are safe and reduce hospital stay and charges. Am Surg 69(5):377–381

    Google Scholar 

  5. Hyams ES, Stifelman MD (2009) The role of robotics for adrenal pathology. Curr Opin Urol 19(1):89–96

    Article  PubMed  Google Scholar 

  6. Gill IS, Sung GT, Hsu TH, Meraney AM (2000) Robotic remote laparoscopic nephrectomy and adrenalectomy: the initial experience. J Urol 164(6):2082–2085

    Article  PubMed  CAS  Google Scholar 

  7. Winter JM, Talamini MA, Stanfield CL, Chang DC, Hundt JD, Dackiw AP, Campbell KA, Schulick RD (2006) Thirty robotic adrenalectomies: a single institution’s experience. Surg Endosc 20(1):119–124

    Article  PubMed  CAS  Google Scholar 

  8. Brunaud L, Bresler L, Ayav A, Zarnegar R, Raphoz AL, Levan T, Weryha G, Boissel P (2008) Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy? Am J Surg 195(4):433–438

    Article  PubMed  Google Scholar 

  9. Morino M, Benincà G, Giraudo G, Del Genio GM, Rebecchi F, Garrone C (2004) Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial. Surg Endosc 18(12):1742–1746

    Article  PubMed  CAS  Google Scholar 

  10. Wu JC, Wu HS, Lin MS, Chou DA, Huang MH (2008) Comparison of robot-assisted laparoscopic adrenalectomy with traditional laparoscopic adrenalectomy -1 year follow-up. Surg Endosc 22(2):463–466

    Article  PubMed  Google Scholar 

Download references

Disclosures

Karen Pineda-Solís, Heriberto Medina-Franco, and Martin J. Heslin have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Mexico, D.F., Mexico

    Karen Pineda-Solís & Heriberto Medina-Franco

  2. Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA

    Martin J. Heslin

  3. Section of Surgical Oncology, The University of Alabama at Birmingham, 1922 Seventh Avenue South, KB 321, Birmingham, AL, 35294, USA

    Martin J. Heslin

Authors
  1. Karen Pineda-Solís
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heriberto Medina-Franco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin J. Heslin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen Pineda-Solís.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pineda-Solís, K., Medina-Franco, H. & Heslin, M.J. Robotic versus laparoscopic adrenalectomy: a comparative study in a high-volume center. Surg Endosc 27, 599–602 (2013). https://doi.org/10.1007/s00464-012-2496-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-012-2496-9

Keywords

Search

Navigation