Robotic adrenalectomy: technical aspects, early results and learning curve

Autor: Annibale D’Annibale, Paolo Mazzocchi, Vito Pende, Graziano Pernazza, Giorgio Lucandri, Igor Monsellato, Giovanni Alfano, Monica De Angelis
Rok vydání: 2012
Předmět:
Zdroj: The International Journal of Medical Robotics and Computer Assisted Surgery. 8:483-490
ISSN: 1478-5951
DOI: 10.1002/rcs.1454
Popis: Background 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>35kg/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 5.22.2 days. The mean size of the resected adrenal mass was 5.12.4cm. 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. Copyright © 2012 John Wiley & Sons, Ltd.
Databáze: OpenAIRE
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