Robotic total and partial adrenalectomy: A step by step approach

Abstract

Objective: While open adrenalectomy was performed for many years, minimally invasive adrenalectomy has become the gold-standard for surgical resection of adrenal masses owing to superior perioperative outcomes. The objective of this video is to describe our technique of performing robot-assisted total and partial adrenalectomy. Patients and surgical procedure: In this video, we use the case of a left-sided aldosteronoma to demonstrate our technique of a left robot-assisted total adrenalectomy and a large right-sided tumor with solid enhancing component and mass effect compressing the IVC to demonstrate a right robot-assisted total adrenalectomy. Additionally, we briefly highlight nuances of performing a partial adrenalectomy and the utility of ultrasound in this setting. Results: There were no intraoperative or postoperative complications. All patients were discharged per our routine pathway on post-operative day one. Through our step-by-step video, we demonstrate our technical approach and tips to successfully perform a robotic total and partial adrenalectomy. Conclusion: Robot-assisted adrenalectomy is an effective and well-established option for the management of adrenal masses. The added dexterity and improved visualization provided by the robotic approach allows surgeons to provide patients with an effective, efficient, and oncologically appropriate operation with rapid convalescence.

Keywords

• Adrenalectomy
• Adrenal gland
• Robotic surgery
• Minimally invasive surgery