Our Summary

This research paper is about a study conducted on the use of robotic single-site (RSS) technology to perform a type of surgery called adrenalectomy - the removal of one or both adrenal glands. The study looked at 33 patients who had this surgery done by one surgeon. The patients varied in age, size, and the reasons they needed the surgery. The study also looked at the size of the adrenal glands that were removed, how long the surgery took, how long the patients stayed in the hospital, how much pain they felt after surgery, and any complications that happened.

The results showed that five of the surgeries had to be switched to a different method part way through, but this wasn’t related to the patient’s age, size, the size of the tumor, or which adrenal gland was being removed. The patients who had a successful surgery using the RSS method were, on average, 55 years old, slightly overweight, and had a tumor about the size of a grape. The surgery took about two hours on average, and most patients reported a moderate level of pain afterwards. Most patients were discharged from the hospital the day after surgery, and almost all were discharged by the second day.

The study also found that the more surgeries the surgeon performed, the faster they were able to do them. However, this didn’t increase the rate of complications. The conclusion of the study was that patients with both functioning and non-functioning tumors, as well as those who are overweight, can be safely treated with this method. The results also suggest that as surgeons gain more experience with this method, they can perform the surgeries more quickly without causing more complications.

FAQs

  1. What are the key considerations when applying robotic single-site (RSS) to adrenalectomy procedures?
  2. How does the surgeon learning curve impact the outcomes of RSS adrenalectomy procedures?
  3. Can patients with functioning and non-functioning tumors, as well as those with obesity, be safely treated with RSS adrenalectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to follow postoperative instructions carefully, including taking pain medication as prescribed, avoiding heavy lifting and strenuous activity, and attending follow-up appointments to monitor recovery and ensure proper healing.

Suitable For

Patients who are typically recommended adrenalectomy include those with functioning adrenal tumors such as pheochromocytoma, aldosteronoma, and Cushing’s syndrome. Additionally, patients with non-functioning adrenal tumors, adrenal incidentalomas, adrenal metastases, and adrenal hyperplasia may also be recommended for adrenalectomy. Patients with obesity can also be considered for adrenalectomy using robotic single-site techniques.

Timeline

Before adrenalectomy:

  • Patient presents with symptoms such as high blood pressure, weight gain, muscle weakness, and/or abdominal pain
  • Diagnostic tests are performed, including blood tests, imaging studies (CT or MRI), and hormone level measurements
  • Decision is made to proceed with adrenalectomy based on the findings
  • Preoperative consultations and evaluations are conducted to assess the patient’s overall health and suitability for surgery

After adrenalectomy:

  • Patient undergoes robotic single-site adrenalectomy procedure
  • Adrenal tumor is successfully removed, with some cases requiring conversion to laparoscopic or open approach
  • Postoperative pain is managed, with most patients experiencing pain scores <4 on a 10-point scale
  • Majority of patients are discharged on postoperative day 1 or 2
  • Patients with functioning and non-functioning tumors, as well as those with obesity, are shown to have good outcomes with RSS-A
  • Surgeon learning curve is associated with shorter operative times, without an increase in complication rates.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with adrenalectomy?
  2. How should I prepare for the surgery, both physically and mentally?
  3. What is the expected recovery time after adrenalectomy?
  4. Will I need to take any medications or make any lifestyle changes after the surgery?
  5. How will adrenalectomy affect my hormone levels and overall health?
  6. Are there any alternative treatments or procedures that I should consider?
  7. What is your experience and success rate with performing adrenalectomies, particularly using robotic single-site technology?
  8. How long have you been performing adrenalectomies using this technique?
  9. What is the expected outcome of the surgery in terms of tumor removal and overall health improvement?
  10. Are there any specific instructions or restrictions I should follow before and after the surgery?

Reference

Authors: Lee GS, Arghami A, Dy BM, McKenzie TJ, Thompson GB, Richards ML. Journal: Surg Endosc. 2016 Aug;30(8):3351-6. doi: 10.1007/s00464-015-4611-1. Epub 2015 Oct 20. PMID: 26487220