Robotic-assisted Laparoscopic Transperitoneal Adrenalectomy: Outcomes of Initial Five Patients

*Abdullah Erdem Canda,1 Kemal Ener,2 Ali Fuat Atmaca,1 Erdal Alkan,3 Ahmet Tunc Ozdemir,4 Serkan Altinova,2 Mevlana Derya Balbay3

1. Department of Urology, School of Medicine, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
2. Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
3. Department of Urology, Memorial Sisli Hospital, Istanbul, Turkey
4. Department of Urology, School of Medicine, Yeditepe University, Istanbul, Turkey
*Correspondence to

Disclosure: The authors have declared no conflicts of interest.
Accepted: 01.05.15
Citation: EMJ Urol. 2015;3[3]:36-40.


Objective: To report the outcomes of transperitoneal robotic adrenalectomy (RA) procedures in five initial cases performed at two institutions.
Methods: Between March 2012 and November 2014, five patients underwent RA. A transperitoneal approach was taken by using the da Vinci-S four-arm surgical robot. Outcomes were assessed retrospectively.
Results: Mean patient age was 42.6±5.1 (range: 34-47) years. Mean body mass index was 30.5±4.5 (range: 23.2-35.2) kg/m². Median tumour size detected on radiological imaging was 3.1±1.7 (range: 1.2-6.0) cm. Mean operation time was 129.0±12.4 (range: 120-150) minutes and median estimated blood loss was 100.0±119.3 (range: 50-350) ml. No intraoperative or perioperative complications occurred according to the modified Clavien complication scale. Median duration of hospital stay was 2.0±1.7 (range: 2-6) days. The fourth robotic arm was used in two patients. Histopathology results demonstrated: metastasis of renal cell carcinoma occurred in 1 case, adrenal cortical adenoma in 2 cases, pheochromocytoma in 1 case, and hyperplasia in 1 case. After a median follow-up of 17.0±15.0 (range: 3-40) months, no local recurrence was detected.
Conclusion: RA is a safe minimally invasive surgical approach that has excellent surgical and oncological outcomes in the treatment of adrenal masses <7 cm in size.

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