Robotic vs. Laparoscopic Adrenalectomy: A Comprehensive Comparison of Surgical Outcomes and Influencing Operative Time

Abstract

OBJECTIVES: This study aimed to compare the perioperative outcomes of robotic adrenalectomy (RA) and laparoscopic adrenalectomy (LA) at Kobe University Hospital. We evaluated operation time, blood loss, complication rates, and hospital length of stay (LOS), as well as factors influencing operation time. METHODS: We reviewed data from patients who underwent RA or LA at Kobe University Hospital between April 2020 and June 2024. Patient characteristics, comorbidities, surgical outcomes, and complications were recorded. Linear and stepwise regression analyses were used to identify factors affecting operation time. RESULTS: A total of 89 LA cases and 49 RA cases were included. No significant differences were found between the groups in terms of operation time, blood loss, or LOS. Rates of surgical complications were comparable between groups. The stepwise regression model identified that laparoscopic technique, male sex, tumor size, and BMI were significant factors influencing operation time. In the RA group, tumor size and BMI had less of an effect on operation time compared to the LA group. Correlation analyses showed that the correlation between operation time and tumor size/BMI was higher in the LA group than in the RA group. CONCLUSIONS: No significant differences were found between RA and LA in terms of perioperative outcomes, though tumor size and BMI may have less of an effect on operation time in RA. These findings support the clinical use of robotic adrenalectomy, particularly in patients with high BMI or large tumors, although further studies are needed.