Skip to main content

Advertisement

SpringerLink
Log in

Robotic single-site adrenalectomy

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Introduction

Technological advances have brought about robotic single-site (RSS) cholecystectomy and hysterectomy. The application of RSS to additional procedures requires careful assessment of the surgeon learning curve, the technological limitations, patient selection criteria and associated outcomes.

Methods

Patient demographics, BMI, surgical indications, adrenal size, OR times, length of stay, postoperative pain and complications were assessed.

Results

Thirty-three patients underwent RSS-A by a single surgeon with 53 % being male, mean age 54 ± 16 years and mean BMI of 32.7. There were 18 left, 10 right, and 5 bilateral procedures for a total of 38 adrenal glands removed (mean tumor size 3.2 cm). There were 5 conversions to a laparoscopic approach, and two to open approach. The necessity for conversion was not associated with age, BMI, tumor size, surgical side or pathology (p > 0.05). The patients who underwent successful unilateral RSS-A had a profile of mean age 55, BMI 31, tumor size 3 cm, and a mean operative time of 118 ± 25.8 min. Pain scores were <4 (10 point scale) in 67 % of patients. 74 % of patients were discharged on POD 1 and 96 % were discharged by POD 2. An assessment of the quartile learning curve for the unilateral RSS-A showed operative times decreased from a mean of 124 to 103 min after 21 cases (p = 0.05).

Conclusion

Patients with functioning and non-functioning tumors, along with those with obesity can safely be treated with RSS-A. The surgeon learning curve was associated with shortened operative times and not increased complication rates.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Morino M, Beninca G, Giraudo G, Del Genio GM, Rebecchi F, Garrone C (2004) Robot-assisted vs. laparoscopic adrenalectomy. Surg Endosc 18:1742–1746

    Article  CAS  PubMed  Google Scholar 

  2. Aksoy E, Taskin HE, Aliyev S, Mitchell J, Sperstein A, Berber E (2013) Robotic versus laparoscopic adrenalectomy in obese patients. Surg Endosc 27:1233–1236

    Article  PubMed  Google Scholar 

  3. Taskin HE, Berber E (2013) Robotic adrenalectomy. Cancer J 1:162–166

    Article  Google Scholar 

  4. Heemskerk J, Zandbergen HR, Keet SW, Martijnse I, van Montfort G, Peters RJ, Svircevic V, Bouwman RA, Baeten CG, Bouvy ND (2014) Relax, it’s just laparoscopy! A prospective randomized trial on heart rate variability of the surgeon in robot-assisted versus conventional laparoscopic cholecystectomy. Dig Surg 31(3):225–232

    Article  PubMed  Google Scholar 

  5. Hubert N, Gilles M, Desbrosses K, Meyer JP, Felblinger J, Hubert J (2013) Ergonomic assessment of the surgeon’s physical workload during standard and robotic assisted laparoscopic procedures. Int J Med Robot 9(2):142–147

    Article  CAS  PubMed  Google Scholar 

  6. Arghami A, Dy B, Bingener J, Osborn J, Richards M (2015) Single-port robotic-assisted adrenalectomy: feasibility, safety, and cost-effectiveness. JSLS 19(1):1–5

    Article  Google Scholar 

  7. Thompson GB, Grant CS, van Heerden JA, Schlinkert RT, Young WF Jr, Farley DR, Ilstrup DM (1997) Laparoscopic versus open posterior adrenalectomy: a case–control study of 100 patients. Surgery 122(6):1132–1136

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  9. Fausto PF, Sebay F, Sierra M, Ippolito G, Souteyard P, Henry JF (2006) Long-term outcome following laparoscopic adrenalectomy for large solid adrenal cortex tumors. World J Surg 30:893–898

    Article  Google Scholar 

  10. Nordenstrom E, Westerdahl J, Hallgrimsson P, Bergenfelz A (2011) A prospective study of 100 robotically assisted laparoscopic adrenalectomies. J Robot Surg 5:127–131

    Article  Google Scholar 

  11. Brunaud L, Ayav A, Zarnegar R, Rouers A, Klein M, Boissel P, Bresler L (2008) Prospective evaluation of 100 robotic-assisted unilateral adrenalectomies. Surgery 144:995–1001

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  13. 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 20:119–124

    Article  CAS  PubMed  Google Scholar 

  14. Pineda-Solis K, Medina-Franco H, Heslin MJ (2013) Robotic versus laparoscopic adrenalectomy: a comparative study in a high-volume center. Surg Endosc 27:599–602

    Article  PubMed  Google Scholar 

  15. Karabulut K, Agcaoglu O, Aliyev S, Siperstein A, Berber E (2012) Comparison of intraoperative time use and perioperative outcomes for robotic versus laparoscopic adrenalectomy. Surgery 151:537–542

    Article  PubMed  Google Scholar 

  16. Svoboda S, Qaqish TR, Wilson A, Park H, Youssef Y (2015) Robotic single-site cholecystectomy in the obese: outcomes from a single institution. Surg Obes Relat Dis 11(4):882–885

    Article  PubMed  Google Scholar 

  17. Clark LH, Soliman PT, Odetto D, Munsell MF, Schmeler KM, Fleming N, Westin SN, Nick AM, Ramirez PT (2013) Incidence of trocar site herniation following robotic gynecologic surgery. Gynecol Oncol 131:400–403

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgement

Scott Harmsen and Courtney Heins for statistical analysis support.

Author information

Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Grace S. Lee, Arman Arghami, Benzon M. Dy, Travis J. McKenzie, Geoffrey B. Thompson & Melanie L. Richards

Authors
  1. Grace S. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arman Arghami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benzon M. Dy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Travis J. McKenzie
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Geoffrey B. Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Melanie L. Richards
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Melanie L. Richards.

Ethics declarations

Disclosures

Grace S. Lee, Arman Arghami, Benzon M. Dy, Travis J. McKenzie, Geoffrey B. Thompson and Melanie L. Richards do not have any conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, G.S., Arghami, A., Dy, B.M. et al. Robotic single-site adrenalectomy. Surg Endosc 30, 3351–3356 (2016). https://doi.org/10.1007/s00464-015-4611-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-015-4611-1

Keywords

Search

Navigation