Robotic versus laparoscopic adrenalectomy: a comparative study in a high-volume center
- 7 September 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 27 (2), 599-602
- https://doi.org/10.1007/s00464-012-2496-9
Abstract
Minimally invasive surgery has become more popular in recent years. The da Vinci® robot is one of the new technologies the use of which has gained popularity in a host of different specialties. Originally used in cardiac surgery, marked increases in utilization have been seen in urology, gynecology, and thoracic surgery. Use in general surgical procedures has now become more common. The objective benefits of the robot are unclear compared to those of laparoscopy in many procedures. The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for adrenalectomy in a high-volume center compared to routine laparoscopic techniques. We conducted a retrospective study including consecutive patients who underwent minimally invasive adrenalectomy in a tertiary referral center at the University of Alabama Birmingham. Demographic, clinical, histopathological, and surgical variables were recorded. Patients were divided in two groups: laparoscopic adrenalectomy (LA) and robot-assisted adrenalectomy (RA). Groups were compared using the χ2 test for categorical variables and Student’s t-test for continuous variables. Significance was considered p < 0.05. Sixty patients were included, with 30 patients in each group. There were no significant differences between groups with respect to demographic variables except there were more pheochromocytoma patients in the LA group than in the RA group (13/30 vs. 5/30, respectively; p = 0.02). This study demonstrated increased operative time in the robotic group (190 ± 33 min) versus the laparoscopic group (160 ± 41 min) (p = 0.003). There was a trend for less blood loss in RA versus LA (30 ± 5 ml vs. 55 ± 74 ml; p = 0.07). There was no mortality. Morbidity and length of hospital stay were similar for both groups. Robotic adrenalectomy is as safe and technically feasible as laparoscopic adrenalectomy. Subjective benefits for the surgeon with robot-assisted surgery include three-dimensional operative view, ergonomically comfortable position, and elimination of the surgeon’s tremor. The operating time is significantly longer but patient outcomes are similar to those of the laparoscopic technique.Keywords
This publication has 10 references indexed in Scilit:
- Robot‐assisted adrenalectomy: a technical option for the surgeon?International Journal of Medical Robotics and Computer Assisted Surgery, 2010
- The role of robotics for adrenal pathologyCurrent Opinion in Urology, 2009
- Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?The American Journal of Surgery, 2008
- Comparison of robot-assisted laparoscopic adrenalectomy with traditional laparoscopic adrenalectomy - 1 year follow-upSurgical Endoscopy, 2007
- Thirty robotic adrenalectomiesSurgical Endoscopy, 2005
- Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trialSurgical Endoscopy, 2004
- Laparoscopic Adrenalectomy and Splenectomy are Safe and Reduce Hospital Stay and ChargesThe American Surgeon, 2003
- ROBOTIC REMOTE LAPAROSCOPIC NEPHRECTOMY AND ADRENALECTOMY: : THE INITIAL EXPERIENCEJournal of Urology, 2000
- Laparoscopic adrenalectomy for nonmalignant disease: improved safety, morbidity, and cost-effectivenessSurgical Endoscopy, 1999
- Laparoscopic Adrenalectomy in Cushing's Syndrome and PheochromocytomaThe New England Journal of Medicine, 1992