Advertisement

Robot-Assisted Laparoscopic Adrenalectomy

  • Pascal Mouracade
  • Jihad Kaouk
Chapter

Abstract

The laparoscopic technology has presented new frontiers to adrenal surgery thus enabling modification and refinement of established conventional procedures. The integration of robots into adrenal surgery has made it feasible to offer alternatives to patients requiring surgical treatment of adrenal disorders. The robotic assistance may allow more surgeons, with limited conventional laparoscopic experience to offer to their patients a mini invasive approach.

Indications for robotic adrenalectomy mirror those of laparoscopic adrenalectomy and include most adrenal tumors, except those concerning adrenocortical carcinoma, which should still be approached preferably with open surgery.

Surgical approach (transperitoneal or retroperitoneal) is determined by surgical goals, patient medical and surgical history and surgeon experience. In studying minimal access adrenalectomy techniques, the effect of operative volume and experience of the surgeon needs to be taken into consideration.

A Systematic review and a meta-analysis of current evidence show that robot-assisted adrenalectomy can be performed safely and effectively with operative time and complication rates similar to laparoscopic adrenalectomy. In addition it can provide the potential advantage of a shorter hospital stay and less blood loss. These findings seem to support the use of robotic surgery for the minimally invasive surgical management of adrenal masses.

Keywords

Adrenalectomy Robot-assisted surgery Transperitoneal Retroperitoneal 

References

  1. 1.
    Broster LR, Hill HG, Greenfield JG. The adreno-genital syndrome associated with cortical hyperplasia; the results of unilateral adrenalectomy. Br J Surg. 1932;19(76):557–70.CrossRefGoogle Scholar
  2. 2.
    Crile GW. Clinical studies of adrenalectomy and sympathectomy. Ann Surg. 1923;88:470–3.Google Scholar
  3. 3.
    Mayo CH. Paroxysmal hypertension with tumor of retroperitoneal nerve. JAMA. 1927;89:1047–50.CrossRefGoogle Scholar
  4. 4.
    Young HH. Techniques for simultaneous exposure and operation on the adrenals. Surg Gynecol Obstet. 1936;63:179–88.Google Scholar
  5. 5.
    Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing’ssyndrome and pheochromocytoma. N Engl J Med. 1992;327:1033.CrossRefPubMedGoogle Scholar
  6. 6.
    Mercan S, Seven R, Ozarmagan S, Tezelman S. Endoscopic retroperitoneal adrenalectomy. Surgery. 1995;118:1071–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Horgan S, Vanuno D. Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2001;11:415–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Zeiger MA, Thompson GB, Duh QY, Hamrahian AH, Angelos P, Elaraj D, Fishman E, Kharlip J. American Association of Clinical Endocrinologists; American Association of Endocrine Surgeons The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract. 2009;15(Suppl 1):1–20.Google Scholar
  9. 9.
    Sprung J, O’Hara JF Jr, Gill IS, Abdelmalak B, Sarnaik A, Bravo EL. Anesthetic aspects of laparoscopic and open adrenalectomy for pheochromocytoma. Urology. 2000;55:339–43.CrossRefPubMedGoogle Scholar
  10. 10.
    Brunt LM. The positive impact of laparoscopic adrenalectomy on complications of adrenal surgery. Surg Endosc. 2002;16:252–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Hallfeldt KK, Mussack T, Trupka A, et al. Laparoscopic lateral adrenalectomy versus open posterior adrenalectomy for the treatment of benign adrenal tumors. Surg Endosc. 2003;17:264–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Shen WT, Lim RC, Siperstein AE, et al. Laparoscopic vs open adrenalectomy for the treatment of primary hyperaldosteronism. Arch Surg. 1999;134:628–31. discussion 631-2CrossRefPubMedGoogle Scholar
  13. 13.
    Thompson GB, Grant CS, van Heerden JA, Schlinkert RT, Young WF Jr, Farley DR, Ilstrup DM. Laparoscopic versus open posterior adrenalectomy: a case-control study of 100 patients. Surgery. 1997;122:1132–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Brunt LM, Doherty GM, Norton JA, Soper NJ, Quasebarth MA, Moley JF. Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. J Am Coll Surg. 1996;183:1–10.PubMedGoogle Scholar
  15. 15.
    Barreca M, Presenti L, Renzi C, Cavallaro G, Borrelli A, Stipa F, Valeri A. Expectations and outcomes when moving from open to laparoscopic adrenalectomy: multivariate analysis. World J Surg. 2003;27:223–8.PubMedGoogle Scholar
  16. 16.
    Wu CT, Chiang YJ, Chou CC, Liu KL, Lee SH, Chang YH, Chuang CK. Comparative study of laparoscopic and open adrenalectomy. Chang Gung Med J. 2006;29:468–73.PubMedGoogle Scholar
  17. 17.
    Hazzan D, Shiloni E, Golijanin D, Jurim O, Gross D, Reissman P. Laparoscopic vs open adrenalectomy for benign adrenal neoplasm. Surg Endosc. 2001;15:1356–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Tanaka M, Tokuda N, Koga H, Kimoto Y, Naito S. Laparoscopic adrenalectomy for pheochr mocytoma: comparison with open adrenalectomy and comparison of laparoscopic surgery for pheochromocytoma versus other adrenal tumors. J Endourol. 2000;14:427–31.CrossRefPubMedGoogle Scholar
  19. 19.
    Imai T, Kikumori T, Ohiwa M, Mase T, Funahashi H. A case-controlled study of laparoscopic compared with open lateral adrenalectomy. Am J Surg. 1999;178:50–3.CrossRefPubMedGoogle Scholar
  20. 20.
    Shikawa T, Sowa M, Nagayama M, Nishiguchi Y, Yoshikawa K. Laparoscopic adrenalectomy: comparison with the conventional approach. Surg Laparosc Endosc. 1997;7:275–80.CrossRefGoogle Scholar
  21. 21.
    Korman JE, Ho T, Hiatt JR, Phillips EH. Comparison of laparoscopic and open adrenalectomy. Am Surg. 1997;63:908–12.PubMedGoogle Scholar
  22. 22.
    Winfield HN, Hamilton BD, Bravo EL, Novick AC. Laparoscopic adrenalectomy: the preferred choice? A comparison to open adrenalectomy. J Urol. 1998;160:325–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Guazzoni G, Montorsi F, Bocciardi A, Da Pozzo L, Rigatti P, Lanzi R, Pontiroli A. Transperitoneal laparoscopic versus open adrenalectomy for benign hyperfunctioning adrenal tumors: a comparative study. J Urol. 1995;153:1597–600.CrossRefPubMedGoogle Scholar
  24. 24.
    Hemal AK, Kumar R, Misra MC, Gupta NP, Chumber S. Retroperitoneoscopic adrenalectomy for pheochromocytoma: comparison with open surgery. JSLS. 2003;7:341–5.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Edwin B, Kazaryan AM, Mala T, Pfeffer PF, Tonnessen TI, Fosse E. Laparoscopic and open surgery for pheochromocytoma. BMC Surg. 2001;1:2.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Inabnet WB, Pitre J, Bernard D, Chapuis Y. Comparison of the hemodynamic parameters of open and laparoscopic adrenalectomy for pheochromocytoma. World J Surg. 2000;24:574–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Brandao LF, Autorino R, Zargar H, et al. Robot-assisted laparoscopic adrenalectomy: step-by-step technique and comparative outcomes. Eur Urol. 2014;66:898–905.CrossRefPubMedGoogle Scholar
  28. 28.
    Brunaud L, Bresler L, Ayav A, Zarnegar R, Raphoz AL, Levan T, Weryha G, Boissel P. Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy? Am J Surg. 2008;195:433–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Nordenstrom E, Westerdahl J, Hallgrimsson P, Bergenfelz A. A prospective study of 100 robotically assisted laparoscopic adrenalectomies. J Robot Surg. 2011;5:127–31.CrossRefPubMedGoogle Scholar
  30. 30.
    Brandao LF, Autorino R, Laydner H, Haber GP, Ouzaid I, De Sio M, Perdonà S, Stein RJ, Porpiglia F, Kaouk JH. Robotic versus laparoscopic adrenalectomy: a systematic review and meta-analysis. Eur Urol. 2014;65(6):1154–61.CrossRefPubMedGoogle Scholar
  31. 31.
    Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, et al. Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol. 2005;19:788–92.CrossRefPubMedGoogle Scholar
  32. 32.
    Maurice MJ, Ramirez D, Kaouk JH. Robotic laparoendoscopic single-site retroperitioneal renal surgery: initial investigation of a purpose-built single-port surgical system. Eur Urol. 2017;71(4):643–7. pii: S0302-2838(16)30275-5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of UrologyGlickman Urological and Kidney Institute, Cleveland ClinicClevelandUSA

Personalised recommendations