Skip to main content
main-content
Erschienen in: Surgical Endoscopy 10/2020

18.11.2019

Safety and feasibility of reduced-port site surgery for robotic posterior retroperitoneal adrenalectomy

verfasst von: Won Woong Kim, Yu-mi Lee, Ki-Wook Chung, Suck Joon Hong, Tae-Yon Sung

Erschienen in: Surgical Endoscopy | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Minimally invasive surgery, such as laparoscopic adrenalectomy and robotic adrenalectomy, has become a treatment of choice for benign adrenal tumors. Efforts are ongoing to minimize the invasiveness of the procedure and to reduce the number of port sites. The primary endpoint of this study was the safety and feasibility of a reduced-port site technique for robotic posterior retroperitoneal adrenalectomy (RPRA).

Methods

This study retrospectively analyzed 74 RPRAs performed by a single surgeon, including 30 conventional three-port site early-phase RPRAs, 30 three-port site late-phase RPRAs, and 14 reduced-port site RPRAs. Reduced-port site RRPA was defined as using two port sites: one for a multi-glove port and one for an additional side port. The clinicopathological features and surgical outcomes were compared in these three groups.

Results

No major complications were observed following RPRA in the three groups of patients. Operation time, pain score, and hospital stay did not differ significantly among these three groups.

Conclusions

RPRA using a reduced-port site system was safe and feasible and may be a good alternative to conventional three-port site RPRA for benign adrenal tumors in certain situations.
Literatur
1.
Zurück zum Zitat Dudley NE, Harrison BJ (1999) Comparison of open posterior versus transperitoneal laparoscopic adrenalectomy. Br J Surg 86:656–660 CrossRef Dudley NE, Harrison BJ (1999) Comparison of open posterior versus transperitoneal laparoscopic adrenalectomy. Br J Surg 86:656–660 CrossRef
2.
Zurück zum Zitat Liao CH, Chen J, Chueh SC, Tu YP, Chen SC, Yuan RH (2001) Effectiveness of transperitoneal and trans-retroperitoneal laparoscopic adrenalectomy versus open adrenalectomy. J Formos Med Assoc 100:186–191 PubMed Liao CH, Chen J, Chueh SC, Tu YP, Chen SC, Yuan RH (2001) Effectiveness of transperitoneal and trans-retroperitoneal laparoscopic adrenalectomy versus open adrenalectomy. J Formos Med Assoc 100:186–191 PubMed
3.
Zurück zum Zitat Berber E, Tellioglu G, Harvey A, Mitchell J, Milas M, Siperstein A (2009) Comparison of laparoscopic transabdominal lateral versus posterior retroperitoneal adrenalectomy. Surgery 146(4):621–625 CrossRef Berber E, Tellioglu G, Harvey A, Mitchell J, Milas M, Siperstein A (2009) Comparison of laparoscopic transabdominal lateral versus posterior retroperitoneal adrenalectomy. Surgery 146(4):621–625 CrossRef
4.
Zurück zum Zitat Fernandez-Cruz L, Saenz A, Taura P, Benarroch G, Astudillo E, Sabater L (1999) Retroperitoneal approach in laparoscopic adrenalectomy: is it advantageous? Surg Endosc 13:86–90 CrossRef Fernandez-Cruz L, Saenz A, Taura P, Benarroch G, Astudillo E, Sabater L (1999) Retroperitoneal approach in laparoscopic adrenalectomy: is it advantageous? Surg Endosc 13:86–90 CrossRef
5.
Zurück zum Zitat Lairmore TC, Folek J, Govednik CM, Snyder SK (2016) Improving minimally invasive adrenalectomy: selection of optimal approach and comparison of outcomes. World J Surg 40:1625–1631 CrossRef Lairmore TC, Folek J, Govednik CM, Snyder SK (2016) Improving minimally invasive adrenalectomy: selection of optimal approach and comparison of outcomes. World J Surg 40:1625–1631 CrossRef
6.
Zurück zum Zitat Okoh AK, Yigitbas H, Berber E (2015) Robotic posterior retroperitoneal adrenalectomy. J Surg Oncol 112:302–304 CrossRef Okoh AK, Yigitbas H, Berber E (2015) Robotic posterior retroperitoneal adrenalectomy. J Surg Oncol 112:302–304 CrossRef
7.
Zurück zum Zitat Samreen S, Fluck M, Hunsinger M, Wild J, Shabahang M, Blansfield JA (2019) Laparoscopic versus robotic adrenalectomy: a review of the national inpatient sample. J Robot Surg 13:69–75 CrossRef Samreen S, Fluck M, Hunsinger M, Wild J, Shabahang M, Blansfield JA (2019) Laparoscopic versus robotic adrenalectomy: a review of the national inpatient sample. J Robot Surg 13:69–75 CrossRef
8.
Zurück zum Zitat Brunaud L, Bresler L, Ayav A, Zarnegar R, Raphoz AL, Levan T, Weryha G, Boissel P (2008) Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy? Am J Surg 195:433–438 CrossRef Brunaud L, Bresler L, Ayav A, Zarnegar R, Raphoz AL, Levan T, Weryha G, Boissel P (2008) Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy? Am J Surg 195:433–438 CrossRef
9.
Zurück zum Zitat Arghami A, Dy BM, Bingener J, Osborn J, Richards ML (2015) Single-port robotic-assisted adrenalectomy: feasibility, safety, and cost-effectiveness. JSLS 19(e2014):00218 PubMed Arghami A, Dy BM, Bingener J, Osborn J, Richards ML (2015) Single-port robotic-assisted adrenalectomy: feasibility, safety, and cost-effectiveness. JSLS 19(e2014):00218 PubMed
10.
Zurück zum Zitat Lee S, Kim JK, Kim YN, Jang DS, Kim YM, Son T, Hyung WJ, Kim HI (2017) Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial. Surg Endosc 31:4002–4009 CrossRef Lee S, Kim JK, Kim YN, Jang DS, Kim YM, Son T, Hyung WJ, Kim HI (2017) Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial. Surg Endosc 31:4002–4009 CrossRef
11.
Zurück zum Zitat 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 (2009) American association of clinical endocrinologists and american association of endocrine surgeons medical guidelines for the management of adrenal incidentalomas: executive summary of recommendations. Endocr Pract 15:450–453 CrossRef 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 (2009) American association of clinical endocrinologists and american association of endocrine surgeons medical guidelines for the management of adrenal incidentalomas: executive summary of recommendations. Endocr Pract 15:450–453 CrossRef
12.
Zurück zum Zitat Taskin HE, Berber E (2012) Robotic adrenalectomy. J Surg Oncol 106:622–625 CrossRef Taskin HE, Berber E (2012) Robotic adrenalectomy. J Surg Oncol 106:622–625 CrossRef
13.
Zurück zum Zitat Okoh AK, Berber E (2015) Laparoscopic and robotic adrenal surgery: transperitoneal approach. Gland Surg 4:435–441 PubMedPubMedCentral Okoh AK, Berber E (2015) Laparoscopic and robotic adrenal surgery: transperitoneal approach. Gland Surg 4:435–441 PubMedPubMedCentral
14.
Zurück zum Zitat Jacobs JK, Goldstein RE, Geer RJ (1997) Laparoscopic adrenalectomy. A new standard of care. Ann Surg 225(5):495–501 CrossRef Jacobs JK, Goldstein RE, Geer RJ (1997) Laparoscopic adrenalectomy. A new standard of care. Ann Surg 225(5):495–501 CrossRef
15.
Zurück zum Zitat Smith CD, Weber CJ, Amerson JR (1999) Laparoscopic adrenalectomy: new gold standard. World J Surg 23:389–396 CrossRef Smith CD, Weber CJ, Amerson JR (1999) Laparoscopic adrenalectomy: new gold standard. World J Surg 23:389–396 CrossRef
16.
Zurück zum Zitat Coste T, Caiazzo R, Torres F, Vantyghem MC, Carnaille B, Do Cao C, Douillard C, Pattou F (2017) Laparoscopic adrenalectomy by transabdominal lateral approach: 20 years of experience. Surg Endosc 31:2743–2751 CrossRef Coste T, Caiazzo R, Torres F, Vantyghem MC, Carnaille B, Do Cao C, Douillard C, Pattou F (2017) Laparoscopic adrenalectomy by transabdominal lateral approach: 20 years of experience. Surg Endosc 31:2743–2751 CrossRef
17.
Zurück zum Zitat Wu S, Lai H, Zhao J, Chen J, Mo X, Zuo H, Lin Y (2016) Laparoendoscopic single-site adrenalectomy versus conventional laparoscopic adrenalectomy: an updated meta analysis. Urol J 13:2590–2598 PubMed Wu S, Lai H, Zhao J, Chen J, Mo X, Zuo H, Lin Y (2016) Laparoendoscopic single-site adrenalectomy versus conventional laparoscopic adrenalectomy: an updated meta analysis. Urol J 13:2590–2598 PubMed
18.
Zurück zum Zitat Han JH, Hong TH, You YK, Kim DG (2017) Surgical results of reduced port laparoscopic adrenalectomy using a multichannel port in comparison with conventional laparoscopic adrenalectomy. Asian J Surg 40:6–11 CrossRef Han JH, Hong TH, You YK, Kim DG (2017) Surgical results of reduced port laparoscopic adrenalectomy using a multichannel port in comparison with conventional laparoscopic adrenalectomy. Asian J Surg 40:6–11 CrossRef
19.
Zurück zum Zitat Machado MT, Nunes-Silva I, da Costa EF, Hidaka AK, Faria EF, Zampolli H, Bezerra CA (2017) Laparoendoscopic single-site retroperitoneoscopic adrenalectomy: bilateral step-by-step technique. Surg Endosc 31:3351–3352 CrossRef Machado MT, Nunes-Silva I, da Costa EF, Hidaka AK, Faria EF, Zampolli H, Bezerra CA (2017) Laparoendoscopic single-site retroperitoneoscopic adrenalectomy: bilateral step-by-step technique. Surg Endosc 31:3351–3352 CrossRef
20.
Zurück zum Zitat Hu Q, Gou Y, Sun C, Xu K, Xia G, Ding Q (2013) A systematic review and meta-analysis of current evidence comparing laparoendoscopic single-site adrenalectomy and conventional laparoscopic adrenalectomy. J Endourol 27:676–683 CrossRef Hu Q, Gou Y, Sun C, Xu K, Xia G, Ding Q (2013) A systematic review and meta-analysis of current evidence comparing laparoendoscopic single-site adrenalectomy and conventional laparoscopic adrenalectomy. J Endourol 27:676–683 CrossRef
21.
Zurück zum Zitat Kan HC, Pang ST, Wu CT, Chang YH, Liu CY, Chuang CK, Lin PH (2017) Robot-assisted laparoendoscopic single site adrenalectomy: a comparison of three different port platforms with 3 case reports. Medicine 96:e9479 CrossRef Kan HC, Pang ST, Wu CT, Chang YH, Liu CY, Chuang CK, Lin PH (2017) Robot-assisted laparoendoscopic single site adrenalectomy: a comparison of three different port platforms with 3 case reports. Medicine 96:e9479 CrossRef
22.
Zurück zum Zitat Narita M, Kageyama S, Okegawa T et al (2018) Urological laparoendoscopic single-site and reduced port surgery: a nationwide survey in Japan. Int J Urol 25:263–268 CrossRef Narita M, Kageyama S, Okegawa T et al (2018) Urological laparoendoscopic single-site and reduced port surgery: a nationwide survey in Japan. Int J Urol 25:263–268 CrossRef
23.
Zurück zum Zitat Sato F, Nakagawa K, Kawauchi A et al (2017) Laparoendoscopic single-site surgeries: a multicenter experience of 469 cases in Japan. Int J Urol 24:69–74 CrossRef Sato F, Nakagawa K, Kawauchi A et al (2017) Laparoendoscopic single-site surgeries: a multicenter experience of 469 cases in Japan. Int J Urol 24:69–74 CrossRef
24.
Zurück zum Zitat Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, Ishida H, Takimoto Y, Saitoh T, Kiyotaki S, Okada K (2005) Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol 19:788–792 CrossRef Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, Ishida H, Takimoto Y, Saitoh T, Kiyotaki S, Okada K (2005) Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol 19:788–792 CrossRef
25.
Zurück zum Zitat Fukumoto K, Miyajima A, Hattori S, Matsumoto K, Abe T, Kurihara I, Jinzaki M, Kikuchi E, Oya M (2017) The learning curve of laparoendoscopic single-site adrenalectomy: an analysis of over 100 cases. Surg Endosc 31:170–177 CrossRef Fukumoto K, Miyajima A, Hattori S, Matsumoto K, Abe T, Kurihara I, Jinzaki M, Kikuchi E, Oya M (2017) The learning curve of laparoendoscopic single-site adrenalectomy: an analysis of over 100 cases. Surg Endosc 31:170–177 CrossRef
Metadaten
Titel
Safety and feasibility of reduced-port site surgery for robotic posterior retroperitoneal adrenalectomy
verfasst von
Won Woong Kim
Yu-mi Lee
Ki-Wook Chung
Suck Joon Hong
Tae-Yon Sung
Publikationsdatum
18.11.2019
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 10/2020
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07273-0

Weitere Artikel der Ausgabe 10/2020

Surgical Endoscopy 10/2020 Zur Ausgabe

Neu im Fachgebiet Chirurgie

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.