Int J Med Robot - Robotic adrenalectomy: technical aspects, early results and learning curve.

Tópicos

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Resumo

CKGROUND: Adrenal surgery is undergoing continuous evolution, and robotic technology may extend indications for a minimally invasive approach to adrenalectomy.METHODS: Thirty robot-assisted unilateral transperitoneal adrenalectomy procedures have been performed at our Department over the last 5 years. The presence of bilateral lesions and vascular involvement were the only contra-indications for a minimally invasive approach. Several patients presented with significant co-morbidities: BMI>35 kg/m(2) (20%); ASA score III-IV (58.7%); and moderate to severe impaired respiratory function (36.6%). In addition, 40% of patients had undergone previous abdominal surgery.RESULTS: Two patients presented with intra-operative complications (6.6%) and only one patient required conversion to an open procedure (3.3%). None of the patients required intraoperative transfusions. Hospital morbidity was 10% but no mortality was recorded. The mean hospital stay was 5.2?2.2 days. The mean size of the resected adrenal mass was 5.1?2.4 cm. A significant reduction in operative times was found with gaining experience.CONCLUSIONS: Thanks to robotic technology, some subpopulations of patients with clinical or oncological contra-indications to laparoscopic treatment may be addressed with minimally invasive treatment.

Resumo Limpo

ckground adren surgeri undergo continu evolut robot technolog may extend indic minim invas approach adrenalectomymethod thirti robotassist unilater transperiton adrenalectomi procedur perform depart last year presenc bilater lesion vascular involv contraind minim invas approach sever patient present signific comorbid bmi kgm asa score iiiiv moder sever impair respiratori function addit patient undergon previous abdomin surgeryresult two patient present intraop complic one patient requir convers open procedur none patient requir intraop transfus hospit morbid mortal record mean hospit stay day mean size resect adren mass cm signific reduct oper time found gain experienceconclus thank robot technolog subpopul patient clinic oncolog contraind laparoscop treatment may address minim invas treatment

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