Robotic assisted versus conventional laparoscopic adrenalectomy for local adrenal neuroblastoma in children: a comparative study

Pediatr Surg Int. 2025 Jun 28;41(1):197. doi: 10.1007/s00383-025-06074-y.

Abstract

Objective: While some case reports have demonstrated the safety and feasibility of robotic assisted laparoscopic adrenalectomy (RA) for treating local adrenal neuroblastoma (NB) in children, it remains unclear whether RA offers advantages over laparoscopic adrenalectomy (LA) in the pediatric population. This study aimed to compare the perioperative outcomes and efficacy of RA and LA for treating pediatric local adrenal NB.

Methods: A retrospective analysis was conducted on pediatric patients who underwent minimally invasive adrenalectomy for local adrenal NB in our hospital between May 2012 and April 2024. Among them, 12 patients (6 females, 6 males) underwent LA, while 10 patients (7 females, 3 males) underwent RA. All procedures were performed via a transperitoneal approach.

Results: The RA group exhibited significantly less intraoperative blood loss (p = 0.036), shorter postoperative drainage duration (p = 0.031), and reduced postoperative hospital stay (p = 0.021) compared to the LA group. No statistically significant differences were observed between the two groups in terms of operative time, conversion rate to open surgery, postoperative complications, or intraoperative hemodynamic parameters.

Conclusion: Our findings suggest that RA and conventional LA are equally safe and effective for treating local adrenal NB. RA offers advantages over LA, including reduced intraoperative blood loss, shorter postoperative drainage duration, and shorter postoperative hospital stay. However, these findings are preliminary and require confirmation through larger, multicenter studies to establish broader clinical implications.

Keywords: Adrenal gland; Adrenalectomy; Children; Da Vinci Xi robotic system; Neuroblastoma.

Publication types

  • Comparative Study

MeSH terms

  • Adrenal Gland Neoplasms* / surgery
  • Adrenalectomy* / methods
  • Blood Loss, Surgical / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Laparoscopy* / methods
  • Length of Stay / statistics & numerical data
  • Male
  • Neuroblastoma* / surgery
  • Operative Time
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Treatment Outcome