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12.08.2016 | ORIGINAL ARTICLE | Ausgabe 7/2016

Langenbeck's Archives of Surgery 7/2016

Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case-control study comparing surgical techniques

Zeitschrift:
Langenbeck's Archives of Surgery > Ausgabe 7/2016
Autoren:
Luca Morelli, Dario Tartaglia, Jessica Bronzoni, Matteo Palmeri, Simone Guadagni, Gregorio Di Franco, Andrea Gennai, Matteo Bianchini, Luca Bastiani, Andrea Moglia, Vincenzo Ferrari, Enza Fommei, Andrea Pietrabissa, Giulio Di Candio, Franco Mosca

Abstract

Purpose

The role of the da Vinci Robotic System® in adrenal gland surgery is not yet well defined. The goal of this study was to compare robotic-assisted surgery with pure laparoscopic surgery in a single center.

Methods

One hundred and 16 patients underwent minimally invasive adrenalectomies in our department between June 1994 and December 2014, 41 of whom were treated with a robotic-assisted approach (robotic adrenalectomy, RA). Patients who underwent RA were matched according to BMI, age, gender, and nodule dimensions, and compared with 41 patients who had undergone laparoscopic adrenalectomies (LA). Statistical analysis was performed using the Student’s t test for independent samples, and the relationship between the operative time and other covariates were evaluated with a multivariable linear regression model. P < 0.05 was considered significant.

Results

Mean operative time was significantly shorter in the RA group compared to the LA group. The subgroup analysis showed a shorter mean operative time in the RA group in patients with nodules ≥6 cm, BMI ≥ 30 kg/m2 and in those who had previous abdominal surgery (p < 0.05). Results from the multiple regression model confirmed a shorter mean operative time with RA with nodules ≥6 cm (p = 0.010). Conversion rate and postoperative complications were 2.4 and 4.8 % in the LA group and 0 and 4.8 % in the RA group.

Conclusions

In our experience, RA shows potential benefits compared to classic LA, in particular on patients with nodules ≥6 cm, BMI ≥ 30 kg/m2, and with previous abdominal surgery.

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