Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center
Objective: In the last years, robotic surgery was introduced in several different settings with good perioperative results. However, its role in the management of adrenal masses is still debated. In order to provide a contribution to this field, we described our step-by-step technique for robotic ad...
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| Language: | English |
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Elsevier
2023-10-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388223000413 |
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| author | Federico Piramide Carlo Andrea Bravi Marco Paciotti Luca Sarchi Luigi Nocera Adele Piro Maria Peraire Lores Eleonora Balestrazzi Angelo Mottaran Rui Farinha Hubert Nicolas Pieter De Backer Frederiek D'hondt Peter Schatteman Ruben De Groote Geert De Naeyer Alexandre Mottrie |
| author_facet | Federico Piramide Carlo Andrea Bravi Marco Paciotti Luca Sarchi Luigi Nocera Adele Piro Maria Peraire Lores Eleonora Balestrazzi Angelo Mottaran Rui Farinha Hubert Nicolas Pieter De Backer Frederiek D'hondt Peter Schatteman Ruben De Groote Geert De Naeyer Alexandre Mottrie |
| author_sort | Federico Piramide |
| collection | DOAJ |
| description | Objective: In the last years, robotic surgery was introduced in several different settings with good perioperative results. However, its role in the management of adrenal masses is still debated. In order to provide a contribution to this field, we described our step-by-step technique for robotic adrenalectomy (RA) and related modifications according to the type of adrenal mass treated. Methods: We retrospectively analyzed 27 consecutive patients who underwent RA at Onze-Lieve-Vrouw hospital (Aalst, Belgium) between January 2009 and October 2022. Demographic, intra- and post-operative, and pathological data were retrieved from our prospectively maintained institutional database. Continuous variables are summarized as median and interquartile range (IQR). Categorical variables are reported as frequencies (percentages). Results: Twenty-seven patients underwent RA were included in the study. Median age, body mass index, and Charlson's comorbidity index were 61 (IQR: 49–71) years, 26 (IQR: 24–29) kg/m2, and 2 (IQR: 0–3), respectively, and 16 (59.3%) patients were male. Median tumor size at computed tomography scan was 6.0 (IQR: 3.5–8.0) cm. Median operative time and blood loss were 105 (IQR: 82–120) min and 175 (IQR: 94–250) mL, respectively. No intraoperative complications were recorded. Overall postoperative complications rate was 11.1%, with a postoperative transfusion rate of 3.7%. A total of 10 (37.0%) patients harbored malignant adrenal masses. Among them, 3 (11.1%) had adrenocortical carcinoma, 6 (22.2%) secondary metastasis, and 1 (3.7%) malignant pheochromocytoma on final pathological exam. Only 1 (10.0%) patient had positive surgical margins. Conclusion: We described our step-by-step technique for RA, which can be safely performed even in case of high challenging settings as malignant tumors, pheochromocytoma, and large masses. The standardization of perioperative protocol should be encouraged to maximize the outcomes of this complex surgical procedure. |
| format | Article |
| id | doaj-art-d71b64ed7d164212bf905538fe0e6769 |
| institution | OA Journals |
| issn | 2214-3882 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-d71b64ed7d164212bf905538fe0e67692025-08-20T02:19:33ZengElsevierAsian Journal of Urology2214-38822023-10-0110447548110.1016/j.ajur.2023.04.001Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic centerFederico Piramide0Carlo Andrea Bravi1Marco Paciotti2Luca Sarchi3Luigi Nocera4Adele Piro5Maria Peraire Lores6Eleonora Balestrazzi7Angelo Mottaran8Rui Farinha9Hubert Nicolas10Pieter De Backer11Frederiek D'hondt12Peter Schatteman13Ruben De Groote14Geert De Naeyer15Alexandre Mottrie16Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy; Corresponding author. Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, Humanitas Research Hospital- IRCCS, Rozzano, ItalyDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, ASST Santi Paolo e Carlo, University of Milan, Milan, ItalyDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, ItalyDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S.Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyORSI Academy, Ghent, BelgiumUrological Department, La Citadelle, Liège, BelgiumORSI Academy, Ghent, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, BelgiumDepartment of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, BelgiumObjective: In the last years, robotic surgery was introduced in several different settings with good perioperative results. However, its role in the management of adrenal masses is still debated. In order to provide a contribution to this field, we described our step-by-step technique for robotic adrenalectomy (RA) and related modifications according to the type of adrenal mass treated. Methods: We retrospectively analyzed 27 consecutive patients who underwent RA at Onze-Lieve-Vrouw hospital (Aalst, Belgium) between January 2009 and October 2022. Demographic, intra- and post-operative, and pathological data were retrieved from our prospectively maintained institutional database. Continuous variables are summarized as median and interquartile range (IQR). Categorical variables are reported as frequencies (percentages). Results: Twenty-seven patients underwent RA were included in the study. Median age, body mass index, and Charlson's comorbidity index were 61 (IQR: 49–71) years, 26 (IQR: 24–29) kg/m2, and 2 (IQR: 0–3), respectively, and 16 (59.3%) patients were male. Median tumor size at computed tomography scan was 6.0 (IQR: 3.5–8.0) cm. Median operative time and blood loss were 105 (IQR: 82–120) min and 175 (IQR: 94–250) mL, respectively. No intraoperative complications were recorded. Overall postoperative complications rate was 11.1%, with a postoperative transfusion rate of 3.7%. A total of 10 (37.0%) patients harbored malignant adrenal masses. Among them, 3 (11.1%) had adrenocortical carcinoma, 6 (22.2%) secondary metastasis, and 1 (3.7%) malignant pheochromocytoma on final pathological exam. Only 1 (10.0%) patient had positive surgical margins. Conclusion: We described our step-by-step technique for RA, which can be safely performed even in case of high challenging settings as malignant tumors, pheochromocytoma, and large masses. The standardization of perioperative protocol should be encouraged to maximize the outcomes of this complex surgical procedure.http://www.sciencedirect.com/science/article/pii/S2214388223000413RoboticsAdrenalectomyPheochromocytomaMalignantSurgical technique |
| spellingShingle | Federico Piramide Carlo Andrea Bravi Marco Paciotti Luca Sarchi Luigi Nocera Adele Piro Maria Peraire Lores Eleonora Balestrazzi Angelo Mottaran Rui Farinha Hubert Nicolas Pieter De Backer Frederiek D'hondt Peter Schatteman Ruben De Groote Geert De Naeyer Alexandre Mottrie Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center Asian Journal of Urology Robotics Adrenalectomy Pheochromocytoma Malignant Surgical technique |
| title | Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center |
| title_full | Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center |
| title_fullStr | Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center |
| title_full_unstemmed | Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center |
| title_short | Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center |
| title_sort | robot assisted adrenalectomy step by step technique and surgical outcomes at a high volume robotic center |
| topic | Robotics Adrenalectomy Pheochromocytoma Malignant Surgical technique |
| url | http://www.sciencedirect.com/science/article/pii/S2214388223000413 |
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