Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?

Background This study evaluates the perioperative outcomes of robotic-assisted adrenalectomy (RA) compared with lateral transperitoneal laparoscopic adrenalectomy (LA). Methods Prospective evaluation of 50 patients who underwent unilateral RA versus 59 patients who underwent unilateral LA. Results RA was associated with lower blood loss (49 mL) but longer operative times (104 minutes) (P <.001). However, the difference in operative time was not significant after the learning curve of 20 cases. In patients with body mass index (BMI) ≥30 kg/m2, mean operative time was longer in the LA group (90 vs 78 minutes, P = .03) but not in the RA group. In patients with large tumors (≥55 mm), mean operative time was longer in the LA group (100 vs 80 minutes, P = .009) but not in the RA group. Conversion rate, morbidity, and hospital stay were similar in both groups. Conclusions After a learning curve of 20 cases, RA has similar perioperative outcomes compared to lateral transperitoneal LA. Several criteria (previous laparoscopic expertise, first assistant’s skill and tumor side) remain determinative on RA operative time.