Robotic retroperitoneoscopic adrenalectomy with DaVinci SP—a single centre experience
Lisa Gunnesson, Marta BerndsenAbstract
Introduction
The anatomical location of the adrenal gland makes a retroperitoneoscopic surgical approach appealing and it has become the primary choice at many centers. Multiport robotic adrenalectomies, however, have preferably been performed transabdominally, as the retroperitoneal space is limited. Advancing single port robotic systems provide access to the retroperitoneum through a single incision combining the advantages of the two techniques.
Methods
Since December 2025 we have performed most adrenalectomies at Sahlgrenska University Hospital by single port robotic retroperitoneoscopy. With the patient in a jackknife position, a 4 cm single incision is made below the twelfth rib, allowing direct access to the retroperitoneum. No additional ports have been needed.
Results
Eighteen patients (ten women, eight men) have been operated so far at our centre. Their age ranged from 37–63 years (mean 50.4, median 49.5) and tumor size ranged from 0–45 mm (mean 18, median 15). Procedure duration ranged from 66–182 min (mean 131, median 135.5). The most common diagnosis was primary aldosteronism (13 patients) followed by pheochromocytoma (three patients). One patient had hypercortisolism, and one had an uncertain lesion. There have been no complications and no conversions to open surgery. In one patient the incision had to be extended to 5 cm due to excessive subcutaneous tissue. Five patients have experienced sensory loss in proximity to the port site. Three of them initially also complained of pain but none has been persistent.
Discussion
Single port robotic retroperitoneoscopic adrenalectomy is safe and allows direct access to the retroperitoneum with sustained robotic precision.