COMPARISON OF ROBOTIC-ASSISTED ADRENALECTOMY USING THE DA VINCI SURGICAL SYSTEM WITH LAPAROSCOPIC AND OPEN APPROACHES: A SYSTEMATIC LITERATURE REVIEW AND META-ANALYSIS
Author(s)
Mansi Mathur, MPH1, Ana Yankovsky, MSc2, Usha Kreaden, MSc3;
1Intuitive Surgical, GAEM Data Analyst, Union City, CA, USA, 2Intuitive Surgical, Palo Alto, CA, USA, 3Intuitive Surgical, Sunnyvale, CA, USA
1Intuitive Surgical, GAEM Data Analyst, Union City, CA, USA, 2Intuitive Surgical, Palo Alto, CA, USA, 3Intuitive Surgical, Sunnyvale, CA, USA
OBJECTIVES: To compare perioperative outcomes of adrenalectomy across robotic-assisted surgery (dV-RAS) using the da Vinci system, laparoscopic-assisted (Lap), and open surgical approaches.
METHODS: A systematic literature review and meta-analysis were conducted using PRISMA methods, analyzing publications identified from PubMed, Scopus, and Embase over a 14-year timespan (2010-2024). Eligible studies compared dV-RAS with Lap and open adrenalectomy, primarily for benign indications (>80%). Studies involving pediatric patients, malignancies, irrelevant outcomes, or redundant data were excluded. Outcomes assessed included operative-time, conversions, transfusions, intraoperative complications, hospital stay (LOS), pain, 30-day complications, surgical site infections (SSI), readmissions, reoperations, mortality.
RESULTS: The analysis included 32 studies: 1 randomized controlled trial (RCT), 5 database studies, and 26 retrospective cohort studies. Compared with Lap, dV-RAS patients were 47% less likely to convert to open surgery (p < 0.01), had 52% lower intraoperative complication rates (p < 0.01), and a shorter length of hospital stay by 0.35 days (approximately 8.4 hours; p < 0.01). No significant differences were observed between the two approaches in operative time, intraoperative complications, index hospitalization pain scores (VAS), blood transfusions, 30-day postoperative complications, readmissions, or mortality. Evidence was insufficient to evaluate perioperative use of pain medications, surgical site infections, and reoperation rates.Evidence comparing RAS with open surgery was limited. Across three studies, , dv-RAS was associated with significantly shorter hospital stay by 4.18 days (p<0.01) and had 92% lower likelihood of requiring blood transfusions. No significant differences were observed in operative time and 30-day postoperative complication rates. Evidence was insufficient to assess other outcomes of interest.
CONCLUSIONS: The dV-RAS is a safe and effective choice for adrenalectomy, with improved or equivalent outcomes. However, limited data on key patient-reported outcomes such as pain, quality of life and recovery metrics underscore the need for high-quality studies that systematically capture these domains to better inform patient-centered surgical decision making.
METHODS: A systematic literature review and meta-analysis were conducted using PRISMA methods, analyzing publications identified from PubMed, Scopus, and Embase over a 14-year timespan (2010-2024). Eligible studies compared dV-RAS with Lap and open adrenalectomy, primarily for benign indications (>80%). Studies involving pediatric patients, malignancies, irrelevant outcomes, or redundant data were excluded. Outcomes assessed included operative-time, conversions, transfusions, intraoperative complications, hospital stay (LOS), pain, 30-day complications, surgical site infections (SSI), readmissions, reoperations, mortality.
RESULTS: The analysis included 32 studies: 1 randomized controlled trial (RCT), 5 database studies, and 26 retrospective cohort studies. Compared with Lap, dV-RAS patients were 47% less likely to convert to open surgery (p < 0.01), had 52% lower intraoperative complication rates (p < 0.01), and a shorter length of hospital stay by 0.35 days (approximately 8.4 hours; p < 0.01). No significant differences were observed between the two approaches in operative time, intraoperative complications, index hospitalization pain scores (VAS), blood transfusions, 30-day postoperative complications, readmissions, or mortality. Evidence was insufficient to evaluate perioperative use of pain medications, surgical site infections, and reoperation rates.Evidence comparing RAS with open surgery was limited. Across three studies, , dv-RAS was associated with significantly shorter hospital stay by 4.18 days (p<0.01) and had 92% lower likelihood of requiring blood transfusions. No significant differences were observed in operative time and 30-day postoperative complication rates. Evidence was insufficient to assess other outcomes of interest.
CONCLUSIONS: The dV-RAS is a safe and effective choice for adrenalectomy, with improved or equivalent outcomes. However, limited data on key patient-reported outcomes such as pain, quality of life and recovery metrics underscore the need for high-quality studies that systematically capture these domains to better inform patient-centered surgical decision making.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
MT6
Topic
Medical Technologies
Disease
SDC: Urinary/Kidney Disorders, STA: Surgery