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

Background: Although several recent studies have demonstrated the feasibility and safety of robotic adrenalectomy, it is unknown whether this procedure has advantages over the traditional laparoscopic approach. This study compared our initial experience using the da Vinci-S® robotic surgical system during laparoscopic adrenalectomy with our experience with traditional laparoscopic adrenalectomy. Methods: From October 2009 to May 2012, 23 consecutive patients (13 women, 10 men) underwent laparoscopic adrenalectomy by the same surgeon at Anam Hospital, Korea University Medical Center. Fifteen patients (9 women, 6 men) underwent robot-assisted adrenalectomy (right-sided, 4 patients; left-sided, 11 patients). Eight patients (4 women, 4 men) underwent traditional laparoscopic adrenalectomy (right-sided, 5 patients; left-sided, 3 patients). The lateral transperitoneal approach was used for all patients. Results: There were no cases of conversion to traditional laparoscopic or open surgery. The mean operative time was longer in the robotic group (208.2minutes, range 120-320) than the laparoscopic group (181.13minutes, range 75-270). There were no cases of intraoperative complications or mortality. The mean hospital stay did not differ significantly between groups (robotic group, 5.86days (SD 1.16); laparoscopic group, 6.71days (SD 1.38)). Conclusions: 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.