Initial experience of a series of robotic-assisted laparoscopic adrenalectomy

Abstract

ObjectivesWe present our initial experience using robotic-assisted laparoscopic adrenalectomy in the surgical treatment of adrenal masses. Material and methodsA total of 18 patients (11 women and 7 men) diagnosed of a functioning or non-functioning adrenal tumor mass were operated on in our facilities between October 2009 and October 2011. Surgical variables, intra-hospital recovery time, pathological findings and peri- and post-operatory findings were evaluated. ResultsMean age of the population intervened was 51.2 years (range 18–81), average ASA score 2.11 (range 1–4) and BMI 27.0 (range 18.8–36.1). Of the 18 patients, 11 were operated on the left side and 7 on the right. Mean surgery time was 150 (range 84–329) min and intra-operatory bleeding 121 (range 10–1500) ml, with a mean loss of hemoglobin and hematocrits of 2.11g/dl and 6.33%, respectively. Two patients were converted to conventional surgery. The factors influencing surgical conversion were: normal size (>10cm), tumor weight (>100g), active pheochromocytoma and left localization of the tumor. Seven functioning cortical adenomas, 6 metastatic adrenal tumors, 3 pheochromocytoma and 2 incidental tumors were excised. Mean tumor size was 5.39 (range 3–15) cm. Median hospital stay was 6 days (range 4–14). Five patients had peri-operatory complication. Of these, only one (5%) had major complications (Clavien III). Mean follow-up was 6 months (range 2–24). ConclusionsRobotic technology for laparoscopic adrenalectomies is a valid option for adrenal tumor treatment. In our experience with a relatively short learning curve, it makes it possible to reduce hospital treatment times and the intra- and post-operatory complications, without affecting the oncological and post-operatory functional results.