Laparoscopic surgery using robots

Mini-invasive adrenalectomy has become popular in recent decades as an alternative to the traditional open procedure. Gagner was the first to implement laparoscopic adrenalectomy into clinical practise in 1992. When compared to open surgery, several studies have shown that laparoscopic surgery is safer and more feasible, with shorter hospital stays, faster recovery, less pain and narcotic use, and fewer peri- and post-operative problem The conventional therapy for benign minor adrenal masses (less than 8 cm) is currently minimally invasive adrenalectomy. Laparoscopic Adrenalectomy (LA) has also been used in the treatment of small (5 cm) malignant adrenal carcinomas in some situations. Alternative techniques, such as lateral retroperitoneal or Posterior Retroperitoneal Adrenalectomy (PRA), have been developed to avoid the requirement for neighbouring tissues to be mobilised and to lessen the risk of complications. Despite drawbacks such as a confined working area and cardiovascular impairment owing to increased insufflation pressures in PRA, laparoscopic PRA (LPRA) has recently proven improved surgical results when compared to Laparotomic Adrenalectomy (LTA). However, there are certain disadvantages of laparoscopic adrenalectomy, including the loss of three-dimensional vision, the unsteady camera platform, and the inflexible apparatus. Recently, mini-invasive robotic adrenalectomy has been introduced as an alternative technique to conventional laparoscopic surgery to overcome the drawbacks of laparoscopic surgery. Robotic equipment offers seven degrees of freedom allowing for delicate movements in limited working spaces. In addition, its 3D optics provides better resolution and depth perception to the surgeon. Finally, its design maximizes the surgeon's comfort during the operation. In addition, robotic adrenalectomy has showed advantages in certain circumstances, especially in the posterior retro-peritoneal approach when dealing with anatomic variations, space is restricted, as is the case with cortical sparing adrenalectomy, which can accomplish a safe resection while lowering post-operative steroid reliance. However, in terms of predicted blood loss, conversion rate, perioperative complications, or total cost, robotic adrenalectomy has yet to show substantial advances, and operating times remain longer than laparoscopic surgery. There is no widespread consensus on the optimum surgical method for adrenalectomy at this time. The goal of this study was to examine the existing data on both procedures in order to determine which was best.