Comparison of intraoperative time use and perioperative outcomes for robotic versus laparoscopic adrenalectomy

Robotic Versus Laparoscopic Adrenalectomy: A Systematic Review and Meta-analysis

“…This fact may have biased some of the outcomes favoring laparoscopy. In the Karabulut et al study, 28 cases were performed by two groups of staff (OR time = 142 ± 12 min) and 22 cases were done by one group of staff and one fellow (OR time: 201 ± 12 min); the difference in operative time was significantly different (p = 0.002) [18]. Agcaoglu et al also reported the presence of a fellow or a resident in almost 50% of surgeries in both groups, but this fact did not affect the operative time significantly [14].…”

“…The other significant outcome in favor of robotic surgery was the lower estimated blood loss, with a difference between groups reaching statistical significance (p = 0.001); seven of the nine studies reported less bleeding for robotics [14], [15], [16], [17], [18] and [19]. However, the detected difference of about 25 ml is not clinically relevant.…”

“…Five of them compared consecutive series of patients (level of evidence [LE]: 3a) [14], [15], [16], [17] and [18], and two performed a retrospective nonconsecutive study (LE: 3b) [19] and [20]. Only one of the studies was an RCT (LE: 2b) [21].…”

“…There were more severe complications in the laparoscopic group, according to the Clavien grading system, including three deaths (Clavien grade 5), two resulting from respiratory failure due to severe pulmonary hypertension [16] and [18] and one from cardiac arrest [25]. You et al reported two grade 4 complications in the laparoscopic group (acute kidney failure and cerebral infarction) requiring intensive care unit treatment [20].…”

Robot-assisted adrenalectomy: current perspectives

“…Most of these studies have been retrospective observational comparative studies, 13,14,[16][17][18][19][20][21][22][23][24]26 and only one of them was a randomized controlled trial. 15 One of the first series comparing LA with robotic adrenalectomy was by Morino et al who evaluated outcomes in 10 patients who underwent laparoscopic and robotic adrenalectomy.…”