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To our knowledge, this is the first study comparing robotic versus laparoscopic resection of pheochromocytoma. Our results show that the robotic approach is similar to the laparoscopic regarding safety and efficacy. The lower morbidity, less immediate postoperative pain, and shorter hospital stay observed in the robotic approach warrant further investigation in future larger studies.

Our study shows that the use of the robot could shorten operative time and decrease the rate of conversion to open for adrenal tumors larger than 5 cm. Based on our favorable experience, robotic adrenalectomy has become our preferred minimally invasive surgical approach for removing large adrenal tumors.

Thirty-one patients who underwent robotic posterior retroperitoneal adrenalectomy and 31 consecutive patients who underwent laparoscopic posterior retroperitoneal adrenalectomy from a prospective institutional review board-approved database.Main Outcome Measures: Demographic and clinical parameters, operative time, presence of complications, length of hospital stay, and pain score on postoperative days 1 and 14. Results:The mean (SEM) tumor sizes for the robotic and laparoscopic groups were similar (3.1 [0.2] and 3.0 [0.2] cm, respectively; P=.48). For all patients, the mean (SEM) skin-to-skin operative times were similar in both groups (163.2 [10.1] and 165.7 [9.5] minutes, respec-

Our study did not show any difference in perioperative outcomes between RA and LA in obese patients. These results suggest that the difficulties in maintaining exposure and dissection in obese patients nullify the advantages of robotic articulating versus rigid laparoscopic instruments in adrenal surgery.

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In this large surgical series, we described the characteristics and oncologic outcomes of patients undergoing resection or RFA for CLM. By having both options available, we were able to surgically treat a large number of patients presenting with different degrees of liver tumor burden and co-morbidities, and also manage liver recurrences in follow-up.

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