Our Summary

This research paper examines the use of robotics in the surgical removal of adrenal glands (adrenalectomy). Some medical professionals are hesitant to adopt this technique due to concerns over longer operation times and the time it takes to become proficient with the new technology. The paper assesses these concerns by reviewing data from two medical institutions.

The study looked at surgeries performed by four surgeons who regularly remove adrenal glands, between 2007 and 2022. Two of these surgeons switched from the traditional method to the robotic one, while the other two learned the robotic method after their formal medical training.

The research found that using robots for this surgery was associated with shorter operation times and fewer complications. It also reduced the need to switch to the traditional open surgery method. Factors that could increase the operation time were being male, being overweight, and having a larger adrenal gland.

The study also looked at how many surgeries it took for a surgeon to become proficient in the robotic method. It found that surgeons typically became proficient after completing between 8 and 29 robotic surgeries. The average surgery time decreased by 14 minutes after 10-20 surgeries, 28 minutes after 20-30 surgeries, and 29 minutes after more than 30 surgeries.

In conclusion, the paper suggests that, with adequate training and support, the adoption of robotic adrenalectomy can be achieved safely in high-volume centers, and the time it takes to become proficient in this method is minimal.

FAQs

  1. What were the results of the study on the effectiveness of using robotics in adrenalectomy surgeries?
  2. How many surgeries does it typically take for a surgeon to become proficient in the robotic method of adrenalectomy?
  3. What factors were found to potentially increase the operation time in robotic adrenalectomy surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about adrenalectomy is to inquire about the possibility of robotic surgery as it may lead to shorter operation times, fewer complications, and a quicker recovery compared to traditional open surgery. It is important to discuss this option with your surgeon to determine if it is the best approach for your specific case.

Suitable For

Patients who are typically recommended adrenalectomy include those with adrenal tumors, such as adrenal adenomas, adrenal cancer, or pheochromocytomas. Adrenalectomy may also be recommended for patients with Cushing’s syndrome, Conn’s syndrome, or other adrenal gland disorders that require surgical intervention. Additionally, patients with adrenal metastases from other cancers may also be candidates for adrenalectomy. Overall, the decision to recommend adrenalectomy for a patient will depend on their specific condition and the recommendation of their healthcare team.

Timeline

Before adrenalectomy:

  • Patient undergoes diagnostic tests to confirm the need for surgery, such as blood tests, imaging scans, and hormone level tests.
  • Patient discusses the risks and benefits of the surgery with their healthcare provider.
  • Patient may need to stop taking certain medications or adjust their diet before the surgery.
  • Patient undergoes pre-operative preparations, such as fasting and anesthesia consultation.

During adrenalectomy:

  • Patient is placed under general anesthesia.
  • Surgeon makes small incisions in the abdomen to insert the robotic instruments.
  • Surgeon uses the robotic system to remove the adrenal gland.
  • Surgery typically lasts between 1-2 hours.
  • Patient is monitored closely in the recovery room before being transferred to a hospital room.

After adrenalectomy:

  • Patient may experience pain and discomfort at the incision site.
  • Patient may need to stay in the hospital for 1-2 days for monitoring.
  • Patient is advised to take pain medication as prescribed and follow post-operative instructions for wound care.
  • Patient may need to follow up with their healthcare provider for monitoring of hormone levels and recovery progress.
  • Patient can gradually resume normal activities and diet as directed by their healthcare provider.

What to Ask Your Doctor

Some questions a patient should ask their doctor about adrenalectomy include:

  1. What are the benefits of robotic adrenalectomy compared to traditional open surgery?
  2. What are the potential risks and complications associated with robotic adrenalectomy?
  3. How many robotic adrenalectomy procedures have you performed, and what is your success rate?
  4. How long does it typically take to recover from robotic adrenalectomy compared to open surgery?
  5. Will I need any additional tests or evaluations before undergoing robotic adrenalectomy?
  6. What is the expected outcome of the surgery in terms of adrenal gland function and overall health?
  7. How long will the operation take, and what is the expected hospital stay?
  8. Are there any specific factors about my health or condition that may affect the success of robotic adrenalectomy?
  9. How many surgeries do you recommend I undergo before you become proficient in the robotic method?
  10. Are there any alternative treatment options to consider before deciding on robotic adrenalectomy?

Reference

Authors: Collins RA, Wang TS, Dream S, Solórzano CC, Kiernan CM. Journal: Ann Surg Oncol. 2023 Jul;30(7):4167-4178. doi: 10.1245/s10434-023-13406-6. Epub 2023 Apr 11. PMID: 37040047