Robotic surgery could pave the way for new perspectives in the removal of the adrenal gland, allowing us to overcome the criticalities still linked to the laparoscopic approach. This is demonstrated by a study published in the prestigious “European Urology Focus” conducted by the doctors of Humanitas and coordinated by Dr. Nicolò Buffi, urologist of the team of Prof. Giorgio Guazzoni.


What is adrenalectomy?

The term adrenalectomy refers to the removal of the adrenal glands, endocrine glands that, as the name suggests, are located above the kidney and are responsible for regulating the response to stress by the synthesis of corticosteroids and catecholamines, including cortisol and adrenalin. Most of the time, the need to remove one of the glands is a consequence of adenomas that produce adrenal substances that cause the blood pressure to rise. In other, less frequent cases it is due to cancer.


What are the contraindications of the laparoscopic approach in the treatment of adrenal diseases?

The adrenalectomy performed by laparoscopy, defined and developed in 1992, was gradually replaced by open surgery, considered the procedure of choice for the treatment of benign diseases of this gland. The contraindication of the laparoscopic approach consists, at present, in the reduced margin of maneuver of the surgical instruments, especially when dealing with voluminous adrenal masses. The study conducted by Humanitas urologists shows that the use of robots can significantly reduce these critical issues, while at the same time reducing the risk of complications.


What aspects did the study of Humanitas’ urologists highlight?

The scientific community has now recognized the many advantages of the robot-assisted approach: reduced blood loss, reduced hospitalization, and reduced complication rate. To date, the large-scale deployment of this procedure has been limited solely by the availability of the Da Vinci robot and the associated costs.

Although the short and long-term results of robot-assisted adrenalectomy have not yet been sufficiently investigated, it seems that, in selected patients, this approach represents a valid option, combining the benefits of minimally invasive surgery with the precision of robotic surgery.