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

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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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Authors and Affiliations

  1. General Surgery Unit, Department of Oncology, Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    Luca Morelli, Dario Tartaglia, Jessica Bronzoni, Matteo Palmeri, Simone Guadagni, Gregorio Di Franco, Andrea Gennai, Matteo Bianchini & Giulio Di Candio

  2. EndoCAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy

    Luca Morelli, Andrea Moglia, Vincenzo Ferrari & Franco Mosca

  3. Institute of Clinical Physiology, National Council of Research, Pisa, Italy

    Luca Bastiani

  4. Fondazione G. Monasterio CNR—Regione Toscana, Pisa, Italy

    Enza Fommei

  5. Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy

    Andrea Pietrabissa

Authors
  1. Luca Morelli
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  2. Dario Tartaglia
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  3. Jessica Bronzoni
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  7. Andrea Gennai
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  9. Luca Bastiani
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  10. Andrea Moglia
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  14. Giulio Di Candio
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  15. Franco Mosca
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Corresponding author

Correspondence to Luca Morelli.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval and informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

As a retrospective study, formal consent is not required.

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Morelli, L., Tartaglia, D., Bronzoni, J. et al. Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case-control study comparing surgical techniques. Langenbecks Arch Surg 401, 999–1006 (2016). https://doi.org/10.1007/s00423-016-1494-0

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  • DOI: https://doi.org/10.1007/s00423-016-1494-0

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