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Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial

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Abstract

Background

The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for disorders of the adrenal gland in terms of feasibility, safety, and length of hospitalization.

Methods

Twenty consecutive patients with benign lesions of adrenal gland were randomized into two groups: Patients in the laparoscopic group underwent traditional laparoscopic adrenalectomy (LAP), whereas those in the robotic group underwent robot-assisted adrenalectomy (ROBOT) using the da Vinci robotic system.

Results

There was no significant difference between the groups in terms of age, sex, body mass index, and size or locations of lesions. Operative times were significant longer in the ROBOT group (total operative time, 169.2 min [range, 136–215] vs 115.3 min (range, 95–155) p < 0.001. Skin-to-skin time was 107 m (range, 77–154) vs 82.1 min (range, 55–120) (p < 0.001). There were no conversions to open surgery. However, conversion to standard laparoscopic surgery was necessary in four of 10 ROBOT patients (40%; left, one right). Perioperative morbidity was higher in the ROBOT group (20% vs 0%). There was no difference in length of hospital stay. In the following ROBOT group, hospital stay was 5.7 days (range, 4–9) vs 5.4 days (range, 4–8) in the LAP group (p = NS). The total cost of the ROBOT procedure ($3,467) was significantly higher than that for LAP ($2,737) (p < 0.01).

Conclusion

Laparoscopic adrenalectomy is superior to robot-assisted adrenalectomy in terms of feasibility, morbidity, and cost.

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References

  1. GH Ballantyne (2002) ArticleTitleThe pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery Surg Laparosc Endosc Percutan Tech 12 1–5 Occurrence Handle10.1097/00129689-200202000-00001 Occurrence Handle12008756

    Article  PubMed  Google Scholar 

  2. G Benincá C Garrone F Rebecchi C Giaccone M Morino (2003) ArticleTitleChirurgia robot-assistita risultati preliminari nel nostro centro Chir Ital 55 321–331

    Google Scholar 

  3. W Bentas M Wolfram R Brautigam J Binder (2002) ArticleTitleLaparoscopic transperitoneal adrenalectomy using a remote-controlled robotic surgical system J Endourol 16 373–376 Occurrence Handle10.1089/089277902760261419 Occurrence Handle12227912

    Article  PubMed  Google Scholar 

  4. FJ Berends E Harst ParticleVan der G Giraudo T Terkivatan G Kazemier HA Bruining WW Herder ParticleDe et al. (2002) ArticleTitleSafe retroperitoneal endoscopic resection of pheochromocytomas World J Surg 26 527–531 Occurrence Handle10.1007/s00268-001-0261-7 Occurrence Handle12098038

    Article  PubMed  Google Scholar 

  5. R Berguer (1998) ArticleTitleSurgical technology and ergonomics of laparoscopic instruments Surg Endosc 12 458–462 Occurrence Handle1:STN:280:DyaK1c3ktVKgsA%3D%3D Occurrence Handle10.1007/s004649900705 Occurrence Handle9569372

    Article  CAS  PubMed  Google Scholar 

  6. L Brunaud L Bresler A Ayav S Tretou L Cormier M Klein P Boissel (2003) ArticleTitleQuels sont les avantages de l’utilisation du système robotique Da Vinci pour réaliser une surrénalectomie unilatérale? Résultats préliminaires Ann Chir 128 530–535 Occurrence Handle1:STN:280:DC%2BD3svotVKqsA%3D%3D Occurrence Handle10.1016/S0003-3944(03)00220-7 Occurrence Handle14559304

    Article  CAS  PubMed  Google Scholar 

  7. GB Cadière J Himpens O Germay R Izizaw M Degueldre J Vandromme E Capelluto et al. (2001) ArticleTitleFeasibility of robotic laparoscopic surgery: 146 cases World J Surg 25 1467–1477

    Google Scholar 

  8. GF Dakin M Gagner (2003) ArticleTitleComparison of laparoscopic skills performance between standard instruments and two surgical robotic systems Surg Endosc 17 574–579 Occurrence Handle1:STN:280:DC%2BD3s7nvFGrug%3D%3D Occurrence Handle10.1007/s00464-002-8938-z Occurrence Handle12582769

    Article  CAS  PubMed  Google Scholar 

  9. JJ Pizzo ParticleDel (2003) ArticleTitleTransabdominal laparoscopic adrenalectomy Curr Urol Rep 4 81–86 Occurrence Handle10.1007/s11934-003-0064-5 Occurrence Handle12537946

    Article  PubMed  Google Scholar 

  10. MM Desai SI Gill JH Kaouk SF Martin GT Sung EL Bravo (2002) ArticleTitleRobotic-assisted laparoscopic adrenalectomy Surg Tech Urol 60 1104–1107

    Google Scholar 

  11. L Fernandez-Cruz P Taura A Saenz G Benarroch L Sabater (1996) ArticleTitleLaparoscopic approach to pheochromocytoma: hemodynamic changes and catecholamine secretion World J Surg 20 762–768 Occurrence Handle1:STN:280:DyaK28vislahsg%3D%3D Occurrence Handle10.1007/s002689900116 Occurrence Handle8678948

    Article  CAS  PubMed  Google Scholar 

  12. M Gagner A Pomp BT Heniford D Pharand A Lacroix (1997) ArticleTitleLaparoscopic adrenalectomy: lesson learned from 100 consecutive procedures Ann Surg 226 238–247 Occurrence Handle1:STN:280:DyaK2svnvFynuw%3D%3D Occurrence Handle10.1097/00000658-199709000-00003 Occurrence Handle9339930 Occurrence Handle1191015

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. IS Gill GT Sung THS Hsu AM Meraney (2000) ArticleTitleRobotic remote laparoscopic nephrectomy and adrenalectomy: the initial experience J Urol 164 2082–2085 Occurrence Handle1:STN:280:DC%2BD3M%2Fns1Cquw%3D%3D Occurrence Handle10.1016/S0022-5347(05)66973-X Occurrence Handle11061931

    Article  CAS  PubMed  Google Scholar 

  14. PC Giulianotti A Coratti M Angelini F Sbrana S Cecconi T Balestracci G Caravaglios (2003) ArticleTitleRobotics in general surgery: personal experience in a large community hospital Arch Surg 138 777–784 Occurrence Handle10.1001/archsurg.138.7.777 Occurrence Handle12860761

    Article  PubMed  Google Scholar 

  15. S Horgan D Vanuno (2001) ArticleTitleRobots in laparoscopic surgery J Laparoendosc Adv Surg Tech 11 415–419 Occurrence Handle1:STN:280:DC%2BD38%2Fos1Gksg%3D%3D Occurrence Handle10.1089/10926420152761950

    Article  CAS  Google Scholar 

  16. F Kockerling H Scheidbach (2000) ArticleTitleCurrent status of laparoscopic colorectal surgery Surg Endosc 14 777–778 Occurrence Handle1:STN:280:DC%2BD3cvkvFGrtw%3D%3D Occurrence Handle10.1007/s004640000326 Occurrence Handle11000352

    Article  CAS  PubMed  Google Scholar 

  17. WS Melvin BJ Needleman KR Krause C Schneider EC Ellison (2002) ArticleTitleComputer-enhanced vs. standard laparoscopic antireflux surgery J Gastrointest Surg 6 11–16 Occurrence Handle10.1016/S1091-255X(01)00032-4 Occurrence Handle11986012

    Article  PubMed  Google Scholar 

  18. E Neugerbauer H Troidl C Kum E Eypasch M Miserez A Paul (1995) ArticleTitleThe EAES Consensus Development Conferences on laparoscopic cholecystectomy appendectomy and hernia repair Surg Endosc 9 550–563

    Google Scholar 

  19. HA Paul WL Bargar B Mittlestadt B Musits RH Taylor P Kazanzides J Zuhars et al. (1992) ArticleTitleDevelopment of a surgical robot for cementless total hip arthoplasty Clin Orthop 285 57–66 Occurrence Handle1446455

    PubMed  Google Scholar 

  20. F Porpiglia C Garrone G Giraudo P Destefanis D Fontana M Morino (2001) ArticleTitleTransperitoneal laparoscopic adrenalectomy: experience in 72 procedures J Endourol 15 257–259 Occurrence Handle10.1089/089277901750161755

    Article  Google Scholar 

  21. RM Satava (2002) ArticleTitleSurgical robotics: the early chronicles Surg Laparosc Endosc Percutan Tech 12 6–16 Occurrence Handle10.1097/00129689-200202000-00002 Occurrence Handle12008765

    Article  PubMed  Google Scholar 

  22. GT Sung IS Gill (2001) ArticleTitleRobotic laparoscopic surgery: a comparison of the Da Vinci and Zeus system Urology 58 893–898 Occurrence Handle1:STN:280:DC%2BD3MnpvV2gsQ%3D%3D Occurrence Handle10.1016/S0090-4295(01)01423-6 Occurrence Handle11744453

    Article  CAS  PubMed  Google Scholar 

  23. JA Young WH Chapman Suffix3rd VB Kim RJ Albrecht PC Ng CW Nifong WR Chitwood SuffixJr (2002) ArticleTitleRobotic-assisted adrenalectomy for adrenal incidentaloma: case report and review of the technique Surg Laparosc Endosc Percutan Tech 12 126–130 Occurrence Handle10.1097/00129689-200204000-00012 Occurrence Handle11948302

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Minimally Invasive Surgery Center, University of Turin, C/O A.M. Dogliotti 14, Turin, 10126, Italy

    M. Morino, G. Benincà, G. Giraudo, G. M. Del Genio, F. Rebecchi & C. Garrone

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  1. M. Morino
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  2. G. Benincà
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  3. G. Giraudo
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  4. G. M. Del Genio
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  5. F. Rebecchi
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  6. C. Garrone
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Correspondence to M. Morino.

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Morino, M., Benincà, G., Giraudo, G. et al. Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial . Surg Endosc 18, 1742–1746 (2004). https://doi.org/10.1007/s00464-004-9046-z

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  • DOI: https://doi.org/10.1007/s00464-004-9046-z

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