Comparison of robotic adrenalectomy with traditional laparoscopic adrenalectomy with a lateral transperitoneal approach: a single‐surgeon experience

Abstract

With its magnified stereoscopic three-dimensional vision, elimination of tremor, and ability to articulate and rotate surgical instruments, the da Vinci-S® robotic system may be an ideal surgical tool for the operation of adrenal lesions. Robotic adrenalectomy appears to be a safe and effective alternative to traditional laparoscopic adrenalectomy.

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.…”

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

“…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].…”

“…Morino et al reported five conversions in the laparoscopic group including four to hand-assisted laparoscopy and one to open surgery [21]. Two studies had no conversions in both groups [15] and [20]. Aliyev et al, who compared both techniques only for pheochromocytomas surgeries, reported one case (3.9%) of conversion for the robotic group that was related to the adherence of tumor to surrounding strictures.…”

“…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]. In the robot-assisted group, there was one grade 3 complication in two studies [16] and [17].…”

Comparison of Modified Retroperitoneal Adrenalectomy With the Gold Standard for Benign Adrenal Tumors

“…With innovated technology and equipment, many surgeons have used adrenalectomy using other procedures aside from conventional laparoscopy; these procedures include laparoendoscopic singlesite (LESS), natural orifice transluminal endoscopic surgery (NOTES), and robotic surgery. [2][3][4] However, further research is still necessary to prove that these methods have considerable advantages over conventional retroperitoneoscopic or transperitonescopic adrenalectomy in terms of operation time, instrument use, and operation simplicity.…”