Safety and feasibility of reduced-port site surgery for robotic posterior retroperitoneal adrenalectomy
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and Other Interventional Techniques
Safety and feasibility of reduced‑port site surgery for robotic posterior retroperitoneal adrenalectomy Won Woong Kim1 · Yu‑mi Lee1 · Ki‑Wook Chung1 · Suck Joon Hong1 · Tae‑Yon Sung1 Received: 4 July 2019 / Accepted: 12 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Minimally invasive surgery, such as laparoscopic adrenalectomy and robotic adrenalectomy, has become a treatment of choice for benign adrenal tumors. Efforts are ongoing to minimize the invasiveness of the procedure and to reduce the number of port sites. The primary endpoint of this study was the safety and feasibility of a reduced-port site technique for robotic posterior retroperitoneal adrenalectomy (RPRA). Methods This study retrospectively analyzed 74 RPRAs performed by a single surgeon, including 30 conventional three-port site early-phase RPRAs, 30 three-port site late-phase RPRAs, and 14 reduced-port site RPRAs. Reduced-port site RRPA was defined as using two port sites: one for a multi-glove port and one for an additional side port. The clinicopathological features and surgical outcomes were compared in these three groups. Results No major complications were observed following RPRA in the three groups of patients. Operation time, pain score, and hospital stay did not differ significantly among these three groups. Conclusions RPRA using a reduced-port site system was safe and feasible and may be a good alternative to conventional three-port site RPRA for benign adrenal tumors in certain situations. Keywords Robotic posterior retroperitoneal adrenalectomy · Reduced-port sites · Two port sites · Benign adrenal tumor Laparoscopic adrenalectomy has become a standard surgical treatment option for patients with benign adrenal diseases, with transperitoneal laparoscopic adrenalectomy being the most frequent type of minimally invasive surgical technique [1, 2]. Alternative approaches, such as lateral retroperitoneal adrenalectomy and posterior retroperitoneal adrenalectomy (PRA), were developed to eliminate the need for mobilization of adjacent structures, including the intestines, spleen, and liver, and to reduce the risk of laparoscopic associated complications [2–4]. PRA has shown benefits over the transperitoneal approach, including fewer complications, less pain, and shorter operation time and hospitalization [5]. Robotic PRA (RPRA) may achieve better outcomes in certain situations, especially in PRA for patients with limited working space [6, 7].
* Tae‑Yon Sung [email protected] 1
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic‑ro 43‑gil, Songpa‑gu, Seoul 05505, South Korea
Minimally invasive surgical techniques, such as laparoscopic and robotic procedures, may be further modified by reducing the number of port sites [8]. In a single-site system, for example, most of the instruments required for surgery are introduced via a single port [9]. A single-site robotic system with magnified camera v
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