• Orhan Agcaoglu, Shamil Aliyev, Koray Karabulut, Allan Siperstein, and Eren Berber.
• Division of Endocrine Surgery, Endocrinology and Metabolism Institute, 9500 Euclid Ave, F20, Cleveland, OH 44195, USA.
• Arch Surg. 2012 Mar 1; 147 (3): 272-5.

ObjectiveTo compare robotic vs laparoscopic posterior retroperitoneal adrenalectomy with regard to perioperative outcomes.DesignProspectively study.SettingTertiary academic center.PatientsThirty-one patients who underwent robotic posterior retroperitoneal adrenalectomy and 31 consecutive patients who underwent laparoscopic posterior retroperitoneal adrenalectomy from a prospective institutional review board-approved database.Main Outcome MeasuresDemographic and clinical parameters, operative time, presence of complications, length of hospital stay, and pain score on postoperative days 1 and 14.ResultsThe mean (SEM) tumor sizes for the robotic and laparoscopic groups were similar (3.1 [0.2] and 3.0 [0.2] cm, respectively; P = .48). For all patients, the mean (SEM) skin-to-skin operative times were similar in both groups (163.2 [10.1] and 165.7 [9.5] minutes, respectively; P = .43). When the last 21 patients who underwent robotic posterior retroperitoneal adrenalectomy were compared with the 31 patients from the laparoscopic series, it was seen that the mean (SEM) operative time was shorter for the robotic group than for the laparoscopic group (139.1 [10.9] vs 166.9 [8.2] minutes; P = .046). The mean (SEM) estimated blood losses and hospital stays were similar between groups. The mean (SEM) pain score on postoperative day 1 was lower in the robotic group than in the laparoscopic group (2.5 [0.3] vs 4.2 [0.4]; P = .008); however, the mean (SEM) pain scores for the groups were similar on postoperative day 14 (P = .53). There were no deaths or cases of morbidity in either group.ConclusionsOur study shows that, beyond the learning curve for experienced laparoscopic surgeons, robotic posterior retroperitoneal adrenalectomy shortens the skin-to-skin operative time compared with the laparoscopic approach. Our results also suggest that the immediate postoperative pain may be less severe for patients who undergo robotic posterior retroperitoneal adrenalectomy.

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