Experience of 243 cases in transperitoneal robotic-assisted laparoscopic surgery for adrenal diseases

Abstract

Objective To summarize our experience in robotic-assisted laparoscopic surgery for adrenal diseases Methods The clinical data of 243 patients with adrenal tumor treated by robotic-assisted laparoscopic surgery from March 2010 to February 2017 were retrospectively reviewed. There were 99 men and 144 women. The mean age was 51.6 years (range, 19-84). Tumors located at left adrenal in 140 cases , right in 97 cases, and both sides in 6 cases. The average diameter was 3.32 cm (range, 0.8-12 cm). However, there were 41 cases whose tumor diameter were greater than 5 cm. Results There were 2 cases of conversion during operation, 1 case converted to open surgery and the other to the traditional laparoscope surgery. The mean operative time was 35 min (range, 20-130 min). Estimated blood loss was 80 ml (range, 20-1 200 ml). Blood transfusion was needed in 6 cases. The mean postoperative hospital stay was 5d (range, 3-20 d). The pathological diagnosis included 37 cases of pheochromocytoma, 149 cases of cortical adenoma, 3 cases of cortical carcinoma, 5 cases of metastatic tumor, 9 cases of adrenal myelolipoma, 3 cases of adrenal cyst, 2 cases of bronchogenic cyst, 25 cases of adrenal nodular hyperplasia, 2 cases of angiomyolipomas, 1 case of mature teratoma, 1case of diffuse large B-Cell lymphoma, 1 case of angioma, and 4 cases of neurofibromatosis. Conclusions Robotic-assisted laparoscopic adrenalectomy was safe and effective. Robotic-assisted laparoscopic surgery has the advantages over laparoscopic surgery in treatment of complicated adrenal tumor, such as large adrenal tumors, pheochromocytoma, bilateral adrenal diseases, overweight and obese patients with adrenal diseases. Key words: Adrenal tumor; Robotic; Laparoscopic; Adrenalectomy