Robot-Assisted Partial Adrenalectomy for Isolated Adrenal Metastasis

Abstract

Adrenal-sparing surgery is an effective and safe alternative to total adrenalectomy for small, benign adrenal lesions and may decrease the risk of the development of adrenal insufficiency. While series of laparoscopic partial adrenalectomy have demonstrated safety and excellent long-term outcomes, there have been no reports of a complete robot-assisted partial adrenalectomy. We believe that robotic techniques may be useful for this procedure, given the complex vascularity and small size of the adrenal gland. Furthermore, there have been no reports of minimally invasive partial adrenalectomy for management of small, isolated adrenal metastasis. We report a case of robot-assisted partial adrenalectomy in a patient with a history of renal-cell carcinoma who had previously undergone contralateral adrenalectomy for metastasis. We report our surgical technique and short-term follow-up for our patient. To our knowledge, this is the first report of a complete robot-assisted partial adrenalectomy and the first report of minimally invasive partial adrenalectomy for an isolated adrenal metastasis.