Robotic partial adrenalectomy: initial report from two tertiary referral centers

Giuseppe Simone1, Gabriele Tuderti1, Leonardo Misuraca1, Antonio Celia2, Bernardino De Concilio2, Antonio Stigliano3, Francesco Minisola1, Mariaconsiglia Ferriero1, Salvatore Guaglianone1, Michele Gallucci1
  • 1 Istituto Nazionale Tumori "Regina Elena", Unità di Urologia (Roma)
  • 2 Ospedale "San Bassiano", Unità di Urologia (Bassano del Grappa)
  • 3 Ospedale "Sant'Andrea", Dipartimento di Medicina Clinica e Molecolare (Roma)


In the era of minimally invasive surgery, partial adrenalectomy has been certainly underused. We aimed to report on postoperative and early functional outcomes of a two-center robotic partial adrenalectomy (RPA) series.

Materials and Methods

From June 2014 to October 2016 RPA was performed on 13 consecutive patients affected by non-functioning adenomas, aldosterone-secreting adenomas and pheochromocytoma (3, 9 and 1, respectively). Preoperative, postoperative and early functional outcomes data were prospectively collected and reported.


All cases were completed robotically. Median nodule size was 29 mm (range 20-40) for non-functioning adenomas, and 17.6 mm (range 10-30) for functioning adrenal masses. Intraoperative blood loss was negligible, postoperative course was uneventful in 12 cases; a single (7.7%) postoperative Clavien grade 2 complication occurred (fever requiring antibiotics); median hospital stay was 3 days (IQR 2-3.5). Patients with hyperaldosteronism became normotensive immediately after surgery (mean preoperative blood pressure: 154/93 mmHg; mean postoperative blood pressure: 120/71 mmHg, respectively). None of the patients required further hypotensive treatment.
Aldosterone and plasmatic renin activity (PRA) levels decreased and returned within the normal range after surgery (mean post-operative aldosterone: 150 pg/ml [ normal range: 17.6-232] and mean post-operative PRA:2.4 ng/ml h [range: 0.2–2.8], respectively).
Postoperative urinary metanephrines of the patient with pheochromocytoma decreased within normal range as well.


RPA is a safe, feasible and minimally invasive surgical approach. The excellent perioperative and early functional outcomes suggest an increasing adoption of this technique in the near future.


-Current trends in partial adrenalectomy.
Colleselli D1, Janetschek G.
Curr Opin Urol. 2015 Mar;25(2):89-94. doi: 10.1097/MOU.0000000000000147.