The DaVinci SyncroSeal is safe for ligating the adrenal vein
Marta Berndsen, Lisa GunnessonAbstract
Introduction
Minimally invasive adrenal surgery is the standard approach for adrenal tumors smaller than 10 cm. Laparoscopic transabdominal and retroperitoneoscopic techniques have been established for decades, while robotic approaches are increasingly adopted. This study assessed the safety of using the da Vinci SynchroSeal as the primary instrument in transabdominal robot-assisted adrenalectomy.
Methods
The study included 42 patients who underwent adrenal surgery at Sahlgrenska University Hospital between October 2024 and April 2026. Patient and operative data were prospectively collected. Ethical approval was obtained.
Results
Eleven patients were female (26%), mean age was 55.5 years (range 30–86), and mean BMI was 27.5 (range 17–38). Four patients had previous upper abdominal surgery. The most common diagnosis was primary hyperaldosteronism in 26 patients (62%), followed by pheochromocytoma in 10 (24%) and metastasis in 3 (7%). Mean tumor size was 23 mm (range 0–70 mm), and 19 patients (45%) underwent right-sided adrenalectomy. Mean operative time was 117 min (range 53–250), and mean console time was 79 min (range 22–212). In all 42 cases, the adrenal vein was sealed with SynchroSeal. Four postoperative complications occurred, none related to vein sealing: myocardial infarction requiring PCI (Clavien–Dindo III), skin infection requiring antibiotics (II), skin hematoma (I), and subcutaneous emphysema (I). Mean length of stay was 1.4 days (range 0–5).
Discussion
Robot-assisted adrenalectomy showed favorable early outcomes. Dissection and sealing of the adrenal vein with SynchroSeal appeared safe.