AB003. 222. Robotic versus laparoscopic adrenalectomy for pheochromocytoma: step-by-step technique of first Irish experience

Background: Recent evidence supports the use of minimally invasive robotic surgery for the surgical management of adrenal masses. Our aim is to describe a current step-by-step technique of robotic adrenalectomy (RA) and to compare outcomes with those of laparoscopic adrenalectomy (LA).

Methods: Four patients underwent LA and one RA for pheochromocytoma by the same surgeon. Data were retrospectively reviewed from a prospectively maintained database. The main steps of the surgical technique for RA are described in the video lecture: patient positioning, port placement, and robot docking; exposure of the adrenal gland; identification and control of the adrenal vein; circumferential dissection of the adrenal gland; and specimen retrieval and closure. Demographic parameters and main surgical outcomes were assessed.

Results: In both groups, skin-to-skin operative time, estimated blood loss less, and intraoperative hemodynamic parameters were similar. There was no conversion to open. There was no morbidity or mortality in either group. Operation time was longer by 20 min in the RA. Blood loss and length of stay were similar.

Conclusions: To our knowledge, this is the first Irish experience comparing robotic versus laparoscopic resection of pheochromocytoma. Our results show that the robotic approach maybe similar to the laparoscopic regarding safety and efficacy. The standardization of each surgical step optimizes the RA procedure.

Keywords: Phaeochromocytoma; adrenal; robotic; laparoscopic; adrenalectomy