Advancing Minimally Invasive Surgery: Robotic Adrenalectomy for Pheochromocytoma—Efficacy, Safety, and Cost-Effectiveness in Focus
Main Article Content
Keywords
Pheochromocytoma, , robotic adrenalectomy, , minimally invasive surgery,
Abstract
Pheochromocytoma, a rare neuroendocrine tumor of the adrenal glands, drives excessive catecholamine production, precipitating hypertension, cardiovascular crises, and systemic symptoms. Laparoscopic adrenalectomy has long been the surgical gold standard, but robotic adrenalectomy is increasingly recognized as a precise, minimally invasive alternative with potential advantages in recovery and operative precision. This narrative review critically evaluates the efficacy, safety, and cost-effectiveness of robotic adrenalectomy for pheochromocytoma, synthesizing evidence from clinical studies to compare perioperative outcomes, complications, and economic impacts against laparoscopic approaches. While robotic techniques demonstrate promising short-term results, including reduced blood loss and shorter hospital stays, the analysis identifies gaps in long-term outcome data and potential publication bias favoring newer technologies. This review underscores the necessity for rigorous prospective studies to validate these findings and refine patient selection criteria. By contextualizing robotic adrenalectomy within the evolving landscape of minimally invasive surgery, this work aims to guide clinical practice, optimize resource allocation, and improve patient-centered care.
References
2. Fishbein L. Imaging findings in pheochromocytoma. Surg Clin North Am. 2021;101(6):1087–99. https://doi.org/10.1016/j.suc.2021.07.001
3. McGowan K, Oldfield EH. The evolving management of pheochromocytoma: A review. World J Surg. 2021;45(2):269–76. https://doi.org/10.1007/s00268-020-05733-x
4. Gleeson ES, Dickson PV, Holt DE, Wiseman JE. Perioperative management of pheochromocytoma: a review. Surg Oncol. 2022;41:101754. https://doi.org/10.1016/j.suronc.2022.101754
5. Zilbermint M, Koller A, Sadowski SM, Kebebew E. Robotic techniques in endocrinology: Comprehensive review of robotic adrenalectomy. J Robot Surg. 2021;15(1):45–53. https://doi.org/10.1007/s11701-020-01010-3
6. Bhandari A, Lam HD, Jyoti S, Sharma A, Singh A. Robotic-assisted adrenalectomy for the treatment of pheochromocytoma: A systematic review and meta-analysis. World J Urol. 2020;38(9):2251–60. https://doi.org/10.1007/s00345-020-03284-0
7. Japanese Society for the Study of von Hippel-Lindau Syndrome. Clinical practice guidelines for the diagnosis and management of pheochromocytoma. Endocr J. 2021;68(10):1049–65. https://doi.org/10.1507/endocrj.EJ20-0565
8. Alkhateeb S, O’Neill K, Ebeling S, Wang TS. Robotic vs open adrenalectomy: an updated meta-analysis. J Endourol. 2021;35(9):1336–47. https://doi.org/10.1089/end.2021.0178
9. Gervais DA, Owen R, Fradley M, Parikh PP. Robotic adrenalectomy for pheochromocytoma: A comparison with laparoscopic adrenalectomy. JSLS. 2021;25(2):e2020.00084. https://doi.org/10.4293/JSLS.2020.00084
10. Koller A, Kaminski M, Ben-Shlomo A, Nilubol N. Long-term outcomes of robotic adrenalectomy for pheochromocytoma: A single-center experience. BJU Int. 2023;131(6):748–54. https://doi.org/10.1111/bju.15753
11. Nakanishi Y, Ushijima T, Ashida R, Otsuka T. Robotic surgery for pheochromocytoma: A new perspective. World J Clin Cases. 2021;9(24):7077–90. https://doi.org/10.12998/wjcc.v9.i24.7077
12. Beyazit Y, Aksoy SH, Yavuz A. Minimal invasive robotic adrenalectomy: The impact of tumor characteristics on outcomes. J Oncol. 2022;2022:2704240. https://doi.org/10.1155/2022/2704240
13. Abdel-Malik M, Gupta S, Farag S, Hanna T. Robotic versus laparoscopic adrenalectomy: A single-center experience. Ann Laparosc Endosc Surg. 2021;6:1–9. https://doi.org/10.21037/ales-20-82
14. Kim H, Park J, Lee S, Kim JH. Efficacy and safety of robotic adrenalectomy for pheochromocytoma: A systematic review and meta-analysis. Surg Endosc. 2023;37(3):1018–27. https://doi.org/10.1007/s00464-022-09135-2
15. Yu K, Smith TR, Patel HD. Cost-effectiveness analysis of robotic adrenalectomy versus open adrenalectomy: A 5-year follow-up. Health Econ Rev. 2023;13:1–10. https://doi.org/10.1186/s13561-023-00422-w
16. Biddle C, Lee D, Patel S. Comparing the economic impact of robotic-assisted surgery to traditional laparoscopic surgery in adrenalectomy. Int J Urol. 2022;29(12):1183–91. https://doi.org/10.1111/iju.14761
17. Ahmed K, Khan MS, Dasgupta P. Robotic-assisted adrenalectomy for pheochromocytoma: A systematic review and meta-analysis. J Endourol. 2023;37(5):559–68. https://doi.org/10.1089/end.2023.0050
18. Kuhlmann JF, Wachtel H, Fraker DL. The role of robotic surgery in adrenalectomy: A review of literature. Curr Urol Rep. 2022;23(2):71. https://doi.org/10.1007/s11934-022-00922-7
19. Doo D, Lee Z, Eun DD. Operative outcomes of robotic adrenalectomy compared to laparoscopic adrenalectomy: Meta-analysis of the literature. Transl Androl Urol. 2021;10(2):640–6. https://doi.org/10.21037/tau-20-1359
20. Mazzitelli G, Piazza P, Mangano A. The effectiveness of robotic surgery in adrenal masses: A systematic review. Gland Surg. 2022;11(6):1351–63. https://doi.org/10.21037/gs-20-36
21. Asari R, Kido M, Tanaka Y. Robotic adrenalectomy: Patient outcomes and management in pheochromocytoma. Korean J Urol. 2021;62(1):49–55. https://doi.org/10.4111/kju.2021.62.1.49.
22. Pham TH, Nguyen DT, Tran TB. Complications of robotic adrenalectomy: A systematic review and meta-analysis. Surg Endosc. 2023;37(2):569–79. https://doi.org/10.1007/s00464-022-09051-3.
23. Coco D, Leanza S. A narrative review of pheochromocytoma in VHL. J Kidney Cancer VHL. 2024;11(1):19–23. https://doi.org/10.15586/jkcvhl.v11i1.275.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.