Robotic adrenalectomy: when and how?

Nomine-Criqui, Claire; Demarquet, L.; Schweitzer, Marie laure; Klein, Marc; Brunaud, Laurent; Bihain, Florence

doi:10.21037/gs.2019.12.11

Cited by 16 publications

(9 citation statements)

References 38 publications

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“… 5 Several reviews have reported rates of conversion from robotic adrenalectomy to laparoscopic and open adrenalectomy as high as 6% and 7%, respectively. 7 , 18 Conversion rates during minimally invasive adrenalectomy are higher for tumors > 6 cm in size, as removal of these large tumors can be technically challenging. However, in a single-center review by Agcaoglu et al comparing 62 patients undergoing robotic (n =24) and laparoscopic (n = 38) adrenalectomy of tumors > 5 cm, the robotic approach was associated with significantly less conversion rates, less blood loss, and a shorter hospital stay despite similar tumor sizes between these groups.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to conventional laparoscopic surgery, this technique is associated with decreased blood loss, reduced patient morbidity, and shorter hospital stay. 4 – 7 Over the past decade, minimally invasive surgery (MIS) departments have gained experience and familiarity with the robotic platform and expanded its utilization into adrenal surgery. Therefore, this study aims to determine the effectiveness and safety profile of transperitoneal robotic adrenalectomy in our MIS practice.…”

Section: Introductionmentioning

confidence: 99%

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Robotic Adrenalectomy: A 10-Year Clinical Experience at a Tertiary Medical Center

Francis

Mellert

Parekh

et al. 2022

JSLS

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic Adrenalectomy: A 10-Year Clinical Experience at a Tertiary Medical Center

Francis

Mellert

Parekh

et al. 2022

JSLS

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“…Summarized data are shown in Table 4. Discussion invasive techniques such as robotic or laparoscopic approaches have importantly increased its usage over the last 20 years since the rst description of robotic adrenalectomy (RA) [11,13,19]. In the present days, LA is considered the gold standard approach to treat adrenal masses, due to lower rates of morbidity, mortality, decreased in-hospital stay, and lower intraoperative blood loss compared with the open approach [2,[7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Outcomes Of Minimally Invasive Adrenalectomy - Do Body Mass Index And Tumor Size Matter? A Single Center Experience

Girón

Rey

Rodríguez³

et al. 2022

Preprint

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Background: Since Gagner performed the first laparoscopic adrenalectomy in 1992, laparoscopy has become the gold-standard procedure in the treatment of adrenal surgical diseases. Literature indicates that the rate of intra- and postoperative complications are not negligible. This study aims to describe the single-center experience of adrenalectomies; and explore the associations between body mass index (BMI) and tumor volume in main postoperative outcomes. Methods: Retrospective observational study with a prospective database in which we described patients who underwent adrenalectomy between January 2015 and December 2020. Operative time, intraoperative blood loss, conversion rate, complications, length of hospital stay, and comparison of the number of antihypertensive drugs used before and after surgery were analyzed. Analysis of BMI and tumor volume with postoperative outcomes such as anti-hypertensive change (AHC) in drug usage and pre-operative conditions were performed. Results: 45 adrenalectomies were performed, all of them were carried out laparoscopically. 4 were performed as a robot-assisted laparoscopy approach. 19 were women and 26 were men. Mean age was 54.9 ± 13.8 years. The mean tumor volume was 95.698 mm3 (Range 3.75 - 1010.87). Mean operative time was shorter in right tumors (2.64 ± 0.75 hours ) than in left tumors (3.33 ± 2.73 hours). Pearson correlation was performed to assess the relationship between BMI and AHC showing a direct relationship between increased BMI and anti-hypertensive drugs usage decrease r(45)= 0.92, p > 0.05 CI 95%. Operative time, Higher tumor volume showed a longer operative time, r(45)=0.6 (p=0.000 CI 95%). Conclusions: Minimally invasive adrenalectomy appears to have an increased impact in patients with higher BMI in terms of postoperative anti-hypertensive usage. Tumor volume seems to be associated with higher operative time and blood loss leading possibly to increased rates of morbidity. Nevertheless, due to our limited number of patients, more studies are needed to replicate and validate these results.

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“…In comparison with open or conventional laparoscopic surgery, robot-assisted surgery potentially reduces not only contamination with body fluids and surgical gasses of the surgical area, but also the number of directly exposed medical staff [31]. This approach is well established also for endocrine surgery [32,33]. Anyway, being a doctor will never be probably the same here forward.…”

Section: The Experience Of the Endocrine Surgery Unit In An Italian Cmentioning

confidence: 99%

Endocrine surgery during COVID-19 pandemic: do we need an update of indications in Italy?

et al. 2020

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The ongoing spread of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a significant threat to global health. As the coronavirus outbreak began spreading, hospitals were forced to relocate resources to treat the growing number of COVID-19 patients. As a consequence, doctors across the country canceled tens of thousands of nonurgent surgeries. However, recognizing that the COVID-19 situation may be highly variable and fluid in different communities across the country, elective surgery could be still allowed in some centers for patients included in the high-priority class. The majority of endocrine disorders requiring surgical treatment in patients identifiable as first-priority class, or needing hospitalization within 30 days, are generally represented by malignant thyroid tumors, hyperthyroidism, hyperparathyroidism, and some adrenal disorders. The need for urgent intervention is evaluated on a case-by-case basis according to the severity of the symptoms, the likelihood of progression, and global clinical judgment. On the basis of the above indications, during the last 4 weeks, we performed 18 planned surgical treatments in patients with thyroid cancer (total thyroidectomies, plus lymph node dissection if needed) or multinodular toxic goiter. In no case, postoperative ventilatory support was needed, and the average hospital stay was 3 days. The negative COVID-19 status for all the treated patients was appropriately evaluated beforehand. Nobody knows how long the current COVID-19 pandemic will be lasting. Certainly, we will be requested in the next future to incrementally offer surgical services for endocrine disorders that have been deferred for the COVID-19 pandemic. Keywords COVID-19 • Endocrine surgery • Thyroid cancer • Endocrine emergencies Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a significant threat to global health [1]. On January 30, 2020, the World Health Organization designated an outbreak of a novel coronavirus not seen before in humans to be a "public health emergency of international concern." Within the first 2 months of the outbreak, the epidemic spread rapidly around the country and the world. As of March 8, 2020, a total of 80,868 confirmed cases and 3101

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Robotic adrenalectomy: when and how?

Abstract: Robotic compared to laparoscopic approachfeasibility and safetyScreening of literature clearly shows that RA is as feasible and as safe as LA. Unfortunately, large prospective

Cited by 16 publications

References 38 publications

Robotic Adrenalectomy: A 10-Year Clinical Experience at a Tertiary Medical Center

Robotic Adrenalectomy: A 10-Year Clinical Experience at a Tertiary Medical Center

Postoperative Outcomes Of Minimally Invasive Adrenalectomy - Do Body Mass Index And Tumor Size Matter? A Single Center Experience

Endocrine surgery during COVID-19 pandemic: do we need an update of indications in Italy?

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