Robotic Retroperitoneal Adrenalectomy for Large Adrenal Lesions Feasibility

Robotic Retroperitoneal Adrenalectomy for large adrenal lesions: Feasibility and Outcomes. Dr Ginil Kumar Pooleri, Dr Vishnu Prasad, Dr Shashank Agrawal, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

Introduction/Purpose:

With the advent of minimally invasive techniques, laparoscopic and robotic adrenalectomy has become the treatment of choice for large adrenal tumours (greater than 5cm). The retroperitoneal route provides a more direct approach, especially in large tumours, with no handling of bowel, resulting in a reduced hospital stay. We present to you our case series of robotic retroperitoneal adrenalectomies (RRA) in large adrenal lesions, including a video of one such case.

Methods/Technique:

We retrospectively analyzed the outcomes of patients with large adrenal masses (greater than 5cm) who underwent robotic retroperitoneal adrenalectomy (RRA) at our centre from 2019-2022. The perioperative outcomes were measured.

Results/Case Presentation:

We had a total of 5 cases. The mean age was 50 years. M:F :: 1 : 4. All had right-sided lesions. Average size was 6.46 cm. Four patients had a functional pheochromocytoma. Mean operating time was 122min. No intraop complications including conversion to open occurred. Mean blood loss was 30ml. Average hospital stay was 2.5 days. The case shown is a 51-year-old female patient who was incidentally detected to have a right adrenal mass during evaluation for palpitations. CT abdomen showed 7.5 * 7.8 cm heterogeneously enhancing necrotic mass in the right adrenal gland. She underwent right RRA with no intra-op complications.

Conclusion:

Robotic retroperitoneal adrenalectomy is feasible, safe, and associated with favourable outcomes in large adrenal tumors.