Robotic assisted laparoscopic adrenalectomy: Initial experience from a tertiary care centre in India

Abstract

INTRODUCTION:Laparoscopic adrenalectomy (LA) is now considered the standard for treatment of surgically correctable adrenal disorders. Robotic adrenalectomy has been performed worldwide and has established itself as safe, feasible and effective approach. We hereby present the first study in robotic transperitoneal LA from Indian subcontinent.MATERIALS AND METHODS:We conducted a retrospective evaluation of 25 patients who had undergone robotic assisted LA at a tertiary health centre by a single surgeon. Demographic, clinical, histopathological and perioperative outcome data were collected and analysed.RESULTS:Mean age of the patients was 45 years (range: 27-65 years). Eleven male and 14 female patients were operated. Mean operative time was 139 min ± 30 min (range: 110-232 min) and mean blood loss was 85 ml ± 12 ml (range: 34-313 ml). Mean hospital stay was 2.5 ± 1.05 days (range: 2-6 days). Mean visual analogue scale score was 3.2 (range: 1-6) mean analgesic requirement was 50 mg diclofenac daily (range: 0-150 mg). Histopathological evaluation revealed 11 adenomas, eight phaeochromocytomas, two adrenocortical carcinomas, and four myelolipomas. According to Clavien-Dindo classification, three patients developed Grade I post-operative complications namely hypotension and pleural effusion.CONCLUSION:Robotic adrenalectomy is safe, technically feasible and comfortable to the surgeon. It is easier to perform with a short learning curve.

Comparison of robot-assisted retroperitoneal laparoscopic adrenalectomy versus retroperitoneal laparoscopic adrenalectomy for large pheochromocytoma: a single-centre retrospective study

“…RLA is a more optimized alternative to open adrenalectomy or transperitoneal laparoscopic adrenalectomy because of the small incision and the lack of mobilization of abdominal organs or intestines for the treatment of large PHEO. Robotic surgery, which represents the most advanced surgical technique in the world, has been reported in recent years for the treatment of PHEO [12][13][14][15][16]. However, most of these reported cases were small-to medium-sized PHEOs, and reports on the treatment of large PHEOs by robotic surgery have been scant.…”

Robotic posterior retroperitoneal adrenalectomy versus laparoscopic posterior retroperitoneal adrenalectomy: outcomes from a pooled analysis

“…Consequently, adrenalectomy for pheochromocytoma presents a substantial challenge for operators. In recent years, several studies have postulated that the robotic platform confers superior therapeutic efficacy in the context of adrenal tumors with pheochromocytoma ( 40 , 41 ). Particularly for pheochromocytomas, neoplasms characterized by a profuse vascular supply, precision in surgical execution holds paramount significance for efficacious hemostatic management.…”

Laparoscopic Adrenalectomy: Tailoring Approaches for the Optimal Resection of Adrenal Tumors

“…Additional methods have been recently introduced, although their widespread adoption is still limited. These include robot-assisted surgery, single-port surgery and hand-assisted laparoscopy [12][13][14][15].…”