Category: Laparoscopic/ Robotic: Other

MP17-2 - Robotic assisted adrenelectomies: an update

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

The role of robot-assisted minimally invasive surgery is developing, with various studies demonstrating safety, feasibility and effectiveness. The laparoscopic approach has been commonplace but the robot offers potential advantages in precision and safety, however, data is still lacking regarding longer term outcomes and efficacy. We aimed to review our procedures over the last 6 years to establish caseload, and assess pathological and surgical outcomes.


Methods :

Retrospective review of tertiary centre operative database between January 2012 and April 2018 identified patients who underwent robotic adrenalectomy. Variables considered were patient demographics, operative parameters including operative time, length of stay, blood loss, histopathology and peri-operative complications.




Results :

27 cases were identified in our cohort. 2 had a simultaneous nephrectomy for another pathology and 1 underwent partial adrenalectomy. Median patient age was 63 (Mean 60.7, Range 27-86). Median operating time was 110 mins (mean 110min). Median blood loss was 55mls (mean 75ml). Pathology is listed below (Table 1) with median lesion size 40mm (mean 42.3mm, range 15 – 100mm).



Table 1


 


Pathology


Number of cases


Metastasis - 11


Phaeochromocytoma - 7


Adenoma - 4


Lymphangioma - 1


Pseudocyst - 1


Adenomatoid tumour - 1


Oncocytoma - 1


Adenocarcinoma - 1


Median LOS was 4 days (mean 3.8 days). There were no intra-operative complications or transfusions with a single Clavien 1 wound haematoma post-operative complication.


Conclusions :

At our centre Robotic Adrenalectomy has been demonstrated as a safe and effective technique. Favourable surgical outcomes and equivalent length of stay were demonstrated compared with the literature for laparoscopic and robotic assisted surgery, whilst allowing for management of complicated endocrine and metastatic lesions.

Luke Foster

Core Surgical Trainee
Guy's and St Thomas'
London, England, United Kingdom

Sanad Saad

Research Fellow
Guys Hospital
London, England, United Kingdom

Benjamin Namdarian

Consultant Urologist
Guy's and St Thomas Foundation Trust
London, England, United Kingdom

Archana Fernando

Guy's Hospital, London
London, England, United Kingdom

Benjamin Challacombe

Consultant Urological Surgeon
Guy's and St. Thomas' Hospitals, London
London, England, United Kingdom