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Robotic Adrenalectomy Using the da Vinci SP Robotic System: Technical Feasibility Comparison with Single-Port Access Using the da Vinci Multi-arm Robotic System

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Laparoscopic adrenalectomy is the gold standard for adrenal tumor; however, robotic adrenal surgery has gained interest recently. For minimally invasive surgeries, we first reported on robotic adrenalectomy using a single-port access performed using the da Vinci multi-arm robotic system (RA-SA) in 2011. Since its introduction in 2018, we first performed robotic adrenalectomy using the da Vinci SP robotic system in 2020.

Objective

We aimed to introduce the novel single-port robotic system (RA-SP) for adrenalectomy and evaluate its technical feasibility by comparing it with the surgical outcomes of patients who underwent robotic adrenalectomy using the RA-SA.

Methods

Eight patients who underwent robotic adrenalectomy using the RA-SP from February 2020 to June 2021 were compared with 11 patients who underwent RA-SA from 2011 to 2015 by a single surgeon.

Results

The two groups were similar in age, sex, body mass index, type of operation, and final pathologic diagnosis. Despite no significant differences, RA-SP resulted in moderately less mean operation time, estimated blood loss, and length of hospitalization.

Conclusions

The Da Vinci SP robotic system is a novel, safe, and feasible technique to improve the convenience of operation and cosmetic effect for adrenalectomy.

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Acknowledgment

The authors would like to thank all nurses who assisted during the surgeries and who contributed to this study.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

    In A Lee MD, Jin Kyong Kim MD, Sang-Wook Kang MD, PhD, Jandee Lee MD, PhD, Jong Ju Jeong MD, PhD, Kee-Hyun Nam MD, PhD & Woong Youn Chung MD, PhD

  2. Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Kwangsoon Kim MD

Authors
  1. In A Lee MD
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  2. Jin Kyong Kim MD
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  3. Kwangsoon Kim MD
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  4. Sang-Wook Kang MD, PhD
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  5. Jandee Lee MD, PhD
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  7. Kee-Hyun Nam MD, PhD
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  8. Woong Youn Chung MD, PhD
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Corresponding authors

Correspondence to Kwangsoon Kim MD or Sang-Wook Kang MD, PhD.

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Disclosure

In A Lee, Jin Kyong Kim, Kwangsoon Kim, Sang-Wook Kang, Jandee Lee, Jong Ju Jeong, Kee-Hyun Nam, and Woong Youn Chung have no conflicts of interest or financial ties to disclose.

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Supplementary Information

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Supplementary Video 1 Console video of a robotic posterior retroperitoneoscopic adrenalectomy with right adrenal tumor using the da Vinci SP robotic system. Using the Maryland dissector, retroperitoneal fatty tissue in the vessel free layer from Gerota’s fascia is pushed away. When found the kidney, we dissected deepen to kidney upper pole. Small vessels around the adrenal gland are coagulated using the Maryland dissector, and fatty tissue is dissected from the upper pole of the kidney, taking care of the accessory renal vessels. Following peri-renal hilar dissection, IVC exposure should be performed before adrenal dissection. On observing the IVC, the dissection is performed continuously along the IVC, and following IVC exposure, lateral dissection is performed. IVC inferior vena cava. (MP4 27059 kb)

Supplementary Video 2 Console video of a robotic posterior retroperitoneoscopic adrenalectomy with right adrenal tumor using the da Vinci SP robotic system. On exposing the central vein of the adrenal gland, a 5 mm Hemolock clip is applied to the adrenal vein. The adrenal gland is then completely mobilized and delivered through a port along with the tumor. (MP4 29524 kb)

Supplementary Video 3 Movement of the robotic arms and camera of the da Vinci SP robotic system. (MP4 25359 kb)

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Lee, I.A., Kim, J.K., Kim, K. et al. Robotic Adrenalectomy Using the da Vinci SP Robotic System: Technical Feasibility Comparison with Single-Port Access Using the da Vinci Multi-arm Robotic System. Ann Surg Oncol 29, 3085–3092 (2022). https://doi.org/10.1245/s10434-021-11208-2

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  • DOI: https://doi.org/10.1245/s10434-021-11208-2

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