Initial Single Center Experience of Robotic Transperitoneal Adrenalectomy

초록

Purpose Laparoscopic transperitoneal adrenalectomy (LTA) is a standard surgical approach for adrenalectomy. As the robotic surgery becomes more popular, robotic adrenalectomy (RA) has been widely performed in worldwide. Since our hospital recently started robotic adrenalectomy, we would like to report the initial results compared to laparoscopic adrenalectomy. Methods From the October 2018 to February 2021, total 40 adrenalectomies were performed by a single endocrine surgeon. We reviewed patients’ medical data and surgical video to find the clinical difference between laparoscopic group and robotic group. After excluding 2 cases of open conversion from laparoscopic approach and 3 cases of open adrenalectomies, 25 patients were included laparoscopic group (LA) and 10 patients were in robotic group (RA). Results RA showed shorter operation time compared to LA group (96.00±23.310 versus 126.20±56.794 minutes, p=0.096). After excluding 4 cases of combined operation for other comorbidity, postoperative hospital stay days were also shorter in RA group (2.67±0.816 versus 3.80±1.848 days, p=0.184). Estimated blood loss (EBL) was less in RA group (130±149.443 versus 170.00±122.474 ml, p=0.147). 1 case of port site hernia was occurred in LA group. Pathologic diagnoses were 22 adrenal cortical adenomas, 8 pheochromocytomas/paragangliomas, 3 adrenal cortical carcinomas and 6 others including pseudocyst, metastatic cancer, lymphangioma, ganglioneuroma, lymphoma and adenomatoid tumor. Conclusion Robotic adrenalectomy showed shorter operation time and reduced hospital stay days compared to laparoscopic surgery. To better assess the safety of robotic adrenal surgery, large number of prospective patient enrollments are needed.