Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Updates in Surgery
Published in: Updates in Surgery 2/2017

01-06-2017 | Review Article

Robot-assisted adrenalectomy: indications and drawbacks

Authors: C. Nomine-Criqui, A. Germain, A. Ayav, L. Bresler, L. Brunaud

Published in: Updates in Surgery | Issue 2/2017

Login to get access

Abstract

Adrenal tumors can vary from a benign adrenocortical adenoma with no hormonal secretion to a secretory adrenocortical malignancy (adrenocortical carcinoma) or a hormone-secreting tumor of the adrenal medulla (pheochromocytoma). Currently, laparoscopic adrenalectomy is regarded as the preferred surgical approach for the management of most adrenal surgical disorders, although there are no prospective randomized trials comparing this technique with open adrenalectomy. However, widespread adoption of robotic technology has positioned robotic adrenalectomy as an option in some medical centers. Speculative advantages associated with the use of the robotic system have rarely been evaluated in clinical settings and cost increase remains an important drawback associated with robotic surgery. This review summarizes current available data regarding robotic transperitoneal adrenalectomy including its indications, advantages, limitations, and comparison with conventional laparoscopic adrenalectomy. We believe that the use of a robotic system seems to be useful especially in more difficult patients with larger tumors, truncal paragangliomas, and bilateral and/or partial adrenalectomies. Overall, we believe that overcosts due to robotic system use could be balanced by hospital stay decrease, patients’ referral increase, improved postoperative outcomes in more difficult patients and ergonomics for the surgeon. However, we also believe that the current surgical intuitive business model is counterproductive, because there are no available strong clinical data that could balance overcosts associated with the use of the robotic system.
Literature
1.
Germain A, Klein M, Brunaud L (2011) Surgical management of adrenal tumors. J Visc Surg 148(4):e250–e261CrossRefPubMed
2.
Brunaud L, Germain A, Zarnegar R, Cuny T, Ayav A, Bresler L (2011) Robot-assisted adrenalectomy. Surg Laparosc Endosc Percutan Tech 21(4):248–254CrossRefPubMed
3.
Nomine-Criqui C, Brunaud L, Germain A, Klein M, Cuny T, Ayav A, Bresler L (2015) Robotic lateral transabdominal adrenalectomy. J Surg Oncol 112(3):305–309CrossRefPubMed
4.
Ball MW, Hemal AK, Allaf ME (2017) International Consultation on Urological Diseases and European Association of Urology International Consultation on Minimally Invasive Surgery in Urology: laparoscopic and robotic adrenalectomy. BJU Int 119(1):13–21CrossRefPubMed
5.
6.
Hyams ES, Stifelman MD (2009) The role of robotics for adrenal pathology. Curr Opin Urol 19:86–96CrossRef
7.
Rosoff JS, Otto BJ, Del Pizzo JJ (2010) The emerging role of robotics in adrenal surgery. Curr Urol Rep 11:38–43CrossRefPubMed
8.
Brunaud L, Bresler L, Ayav A et al (2008) Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy? Am J Surg 195:433–438CrossRefPubMed
9.
Brunaud L, Ayav A, Zarnegar R et al (2008) Prospective evaluation of 100 robotic-assisted adrenalectomies. Surg 144:995–1001CrossRef
10.
Giulianotti PC, Buchs NC, Addeo P et al (2011) Robot-assisted adrenalectomy: a technical option for the surgeon? Int J Med Robot Comput Assist Surg 7:27–32CrossRef
11.
D’Annibale A, Lucandri G, Monsellato I et al (2012) Robotic adrenalectomy: technical aspects, early results and learning curve. Int J Med Robot Comput Assist Surg 8:483–490CrossRef
12.
Pineda-Solís K, Medina-Franco H, Heslin MJ (2013) Robotic versus laparoscopic adrenalectomy: a comparative study in a high-volume center. Surg Endosc 27(2):599–602CrossRefPubMed
13.
You JY, Lee HY, Son GS, Lee JB, Bae JW, Kim HY (2013) Comparison of robotic adrenalectomy with traditional laparoscopic adrenalectomy with a lateral transperitoneal approach: a single-surgeon experience. Int J Med Robot 9(3):345–350CrossRefPubMed
14.
Morino M, Benincà G, Giraudo G, Del Genio GM, Rebecchi F, Garrone C (2004) Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial. Surg Endosc 18(12):1742–1746CrossRefPubMed
15.
16.
Gumbs AA, Gagner M (2006) Laparoscopic adrenalectomy. Best Pract Res Clin Endocrinol Metab 20:483–499CrossRefPubMed
17.
Brandao LF, Autorino R, Laydner H, Haber GP, Ouzaid I, De Sio M, Perdonà S, Stein RJ, Porpiglia F, Kaouk JH (2014) Robotic versus laparoscopic adrenalectomy: a systematic review and meta-analysis. Eur Urol 65(6):1154–1161CrossRefPubMed
18.
Agcaoglu O, Aliyev S, Karabulut K, Mitchell J, Siperstein A, Berber E (2012) Robotic versus laparoscopic resection of large adrenal tumors. Ann Surg Oncol 19(7):2288–2294CrossRefPubMed
19.
Morelli L, Tartaglia D, Bronzoni J et al (2016) Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case–control study comparing surgical techniques. Langenbecks Arch Surg 401(7):99–1006CrossRef
20.
Brunaud L, Ayav A, Zarnegar R, et al. (2008) Robotic versus laparoscopic adrenalectomy: a case control study of 96 patients (oral communication). In: European Society of Endocrine Surgery (ESES) Third Meeting, Barcelona, April 2008
21.
Brunaud L, Bresler L, Zarnegar R, Ayav A, Cormier L, Tretou S, Boissel P (2004) Does robotic adrenalectomy improve patient quality of life when compared to laparoscopic adrenalectomy? World J Surg 28(11):1180–1185CrossRefPubMed
22.
Aksoy E, Taskin HE, Aliyev S, Mitchell J, Siperstein A, Berber E (2013) Robotic versus laparoscopic adrenalectomy in obese patients. Surg Endosc 27(4):1233–1236CrossRefPubMed
23.
Maker AV, Maker VK (2016) Techniques to perform robotic left adrenalectomy in the obese patient. Surg Endosc 31(2):950CrossRefPubMed
24.
25.
Ippolito G, Palazzo FF, Sebag F, Thakur A, Cherenko M, Henry JF (2008) Safety of laparoscopic adrenalectomy in patients with large pheochromocytomas: a single institution review. World J Surg 32(5):840–844CrossRefPubMed
26.
Choh MS, Madura JA 2nd (2009) The role of minimally invasive treatments in surgical oncology. Surg Clin N Am 89(1):53–77CrossRefPubMed
27.
Palazzo FF, Sebag F, Sierra M, Ippolito G, Souteyrand P, Henry JF (2006) Long-term outcome following laparoscopic adrenalectomy for large solid adrenal cortex tumors. World J Surg 30(5):893–898CrossRefPubMed
28.
29.
Shen WT, Sturgeon C, Duh QY (2005) From incidentaloma to adrenocortical carcinoma: the surgical management of adrenal tumors. J Surg Oncol 89(3):186–192CrossRefPubMed
30.
Asher KP, Gupta GN, Boris RS, Pinto PA, Linehan WM, Bratslavsky G (2011) Robot-assisted laparoscopic partial adrenalectomy for pheochromocytoma: the National Cancer Institute technique. Eur Urol 60(1):118–124CrossRefPubMedPubMedCentral
31.
Boris RS, Gupta G, Linehan WM, Pinto PA, Bratslavsky G (2011) Robot-assisted laparoscopic partial adrenalectomy: initial experience. Urology 77(4):775–780CrossRefPubMed
32.
Walz MK, Alesina PF, Wenger FA, Koch JA, Neumann HP, Petersenn S, Schmid KW, Mann K (2006) Laparoscopic and retroperitoneoscopic treatment of pheochromocytomas and retroperitoneal paragangliomas: results of 161 tumors in 126 patients. World J Surg 30(5):899–908CrossRefPubMed
33.
Park JS, Lee KY, Kim JK, Yoon DS (2009) The first laparoscopic resection of extra-adrenal pheochromocytoma using the da Vinci robotic system. J Laparoendosc Adv Surg Tech A 19(1):63–65CrossRefPubMed
34.
Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, Naruse M, Pacak K, Young WF Jr., Endocrine Society (2014) Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99(6):1915–1942CrossRefPubMed
35.
Takata MC, Kebebew E, Clark OH, Duh QY (2008) Laparoscopic bilateral adrenalectomy: results for 30 consecutive cases. Surg Endosc 22(1):202–207CrossRefPubMed
36.
Taskin HE, Aliyev S, Aksoy E, Hamrahian A, Siperstein A, Berber E (2014) Bilateral posterior retroperitoneal robotic adrenalectomy for ACTH-independent Cushing syndrome. Surg Laparosc Endosc Percutan Tech. 24(3):e113–e115CrossRefPubMed
37.
Raffaelli M, Brunaud L, De Crea C, Hoche G, Oragano L, Bresler L, Bellantone R, Lombardi CP (2014) Synchronous bilateral adrenalectomy for Cushing’s syndrome: laparoscopic versus posterior retroperitoneoscopic versus robotic approach. World J Surg 38(3):709–715CrossRefPubMed
38.
Lee GS, Arghami A, Dy BM, McKenzie TJ, Thompson GB, Richards ML (2016) Robotic single-site adrenalectomy. Surg Endosc 30(8):3351–3356CrossRefPubMed
39.
Pavan N, Autorino R, Lee H et al (2016) Impact of novel techniques on minimally invasive adrenal surgery: trends and outcomes from a contemporary international large series in urology. World J Urol 34(10):1473–1479CrossRefPubMed
40.
Bodner J, Augustin F, Wykypiel H, Fish J, Muehlmann G, Wetscher G, Schmid T (2005) The da Vinci robotic system for general surgical applications: a critical interim appraisal. Swiss Med Wkly 135(45–46):674–678PubMed
41.
Winter JM, Talamini MA, Stanfield CL, Chang DC, Hundt JD, Dackiw AP, Campbell KA, Schulick RD (2006) Thirty robotic adrenalectomies: a single institution’s experience. Surg Endosc 20(1):119–124CrossRefPubMed
42.
Aliyev S, Karabulut K, Agcaoglu O, Wolf K, Mitchell J, Siperstein A, Berber E (2013) Robotic versus laparoscopic adrenalectomy for pheochromocytoma. Ann Surg Oncol 20(13):4190–4194CrossRefPubMed
Metadata
Title
Robot-assisted adrenalectomy: indications and drawbacks
Authors
C. Nomine-Criqui
A. Germain
A. Ayav
L. Bresler
L. Brunaud
Publication date
01-06-2017
Publisher
Springer Milan
Published in
Updates in Surgery / Issue 2/2017
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-017-0448-6

Other articles of this Issue 2/2017

Updates in Surgery 2/2017 Go to the issue

Original Article

Transoral endoscopic thyroidectomy: preliminary experience in Italy

Original Article

Locally invasive thyroid cancer: options for a treatment

FOREWORD

Endocrine surgery: an update

Original Article

Risk factors for postoperative hypocalcemia

Technical Note

Retroperitoneoscopic adrenalectomy: tips and tricks

Review Article

Open adrenalectomy in the era of laparoscopic surgery: a review