측면 경복강 접근을 이용한 로봇 부신 절제술: 초기 연속 15예 수술 경험 보고

Abstract

Purpose: In this study, we report on our initial experience using the da Vinci-SⓇ robotic surgical system in performance of laparoscopic adrenalectomy. Methods: Fifteen patients, 11 with left adrenal tumors and four with right adrenal tumors, underwent robotic adrenalectomies using the lateral transperitoneal approach with the da Vinci-SⓇ surgical system at the Korea University Anam Hospital, Seoul, Korea, between October 2009 and May 2012. Results: The mean age of the patients was 45.5 (22∼61) years, and the mean body mass index was 23.81 (18.0∼28.57) kg/m2. Eleven left adrenalectomies, four for primary aldosteronisms, four for pheochromocytomas, two for primary adrenal Cushing’s adenoma, and one for myelolipoma, and four right adrenalectomies, two for the primary adrenal Cushing’s adenomas, one for pheochromocytoma, and one for primary aldosteronism, were performed robotically. There was no conversion to traditional laparoscopic or open surgery. The mean size of the tumor was 2.54 (1.0∼5.5) cm. The mean operative time was 208.2 (120∼320) minutes, and the mean console time was 127.6 (75∼212) minutes. No major postoperative morbidity was observed, and the mean length of hospital stay was 5.86 days. Conclusion: We found that the robotic systems, with magnified stereoscopic three-dimensional vision, elimination of tremor, and the ability to articulate and rotate the instruments, were ideal surgical tools for operation of adrenal lesion. Robotic adrenalectomy may be a safe and effective alternative to traditional laparoscopic adrenalectomy.