Laparoscopic/ Robotic: Other

Moderated Poster Session

MP17-2 - Robotic assisted adrenelectomies: an update

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 252B

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'

My name is Dr Luke Foster, I am a Urology Core Surgical Trainee at Guy's Hospital, London.

I have an interest in mobile app development and have developed two apps with Professor Green (Whipps Cross) for patients with lower urinary tract symptoms; My Waterworks and My Bladder Problem.

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    Sanad Saad

    Research Fellow
    Guys Hospital

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      Benjamin Namdarian

      Consultant Urologist
      Guy's and St Thomas Foundation Trust

      Ben is a consultant urological surgeon with a special interest in the utilisation of technology in urological practice, minimally invasive treatments of prostatic and renal diseases, as well as the management of congenital disorders in Transitional Urology.

      Ben was awarded his urological fellowship with the Royal Australasian College of Surgeons in 2016 having trained Anthony Costello in Australia, his thesis looking into novel cancer neovascularisation biomarkers. He then undertook fellowships in Robotics at Guy’s and St Thomas’ Trust under Ben Challacombe and Prokar Dasgupta, followed by Adolescent/Transition Urology with Dan Wood at University College London Hospital.

      Ben has adopted and helped to disseminate various techniques in prostate cancer diagnostics and BPH treatments such as Urolift and HoLEP within the NHS. With Ben Challacombe he has helped to establish a robotic reconstructive service at Guy's Hospital and at UCLH Ben established Mitrofanoff laser stone treatment. Most recently he coordinated the introduction of a Transperineal Biopsy service at Lewisham and Greenwich Trust in London, whilst in Sydney, Australia he facilitated launching the Biobot Monalisa robotic fusion transperineal prostate biopsy platform.

      Ben has published widely across diverse urological disciplines and has written a number of book chapters on robotics and Urological anatomy. His current research interests are in robotic surgical training, trans-perineal template biopsy techniques and extending the role of technology in reconstructive surgery. Ben has been involved in robotic surgery for over 10 years and is keen to see the technology's role expanded.

      Ben enjoys singing having been a principle tenor with Victorian Opera and Melbourne Symphony Orchestra as well as routinely cycling fundraising events. He is fortunate to have a supportive wife and three young daughters.

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        Archana Fernando

        Guy's Hospital, London

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          Benjamin Challacombe

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

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