Robotic partial adrenalectomy for aldosterone secreting adenomas: initial report from two tertiary referral centers

Giuseppe Simone1, Gabriele Tuderti1, Leonardo Misuraca1, Antonio Celia2, Bernardino De Concilio2, Antonio Stigliano3, Francesco Minisola1, Mariaconsiglia Ferriero1, Salvatore Guaglianone1, Michele Gallucci1
  • 1 Istituto Nazionale Tumori "Regina Elena" (Roma)
  • 2 Ospedale "San Bassiano", S.C. Urologia (Bassano del Grappa)
  • 3 Ospedale "Sant'Andrea", Dipartimento di Medicina Clinica e Molecolare (Roma)


In the era of minimally invasive surgery, partial adrenalectomy has been certainly underused. We aimed to report
on postoperative and early functional outcomes of a two-center robotic partial adrenalectomy (RPA) series.

Materials and Methods

From June 2014 to June 2017 RPA was performed on 10 consecutive patients affected by aldosterone-secreting adenomas. Preoperative,
postoperative and early functional outcomes data were prospectively collected and reported.


All cases were completed robotically. Median nodule size was 18,1 mm (range 10-30) (Table 1). Intraoperative blood loss was negligible,
postoperative course was uneventful in 9 cases; a single (10%) postoperative Clavien grade 2 complication occurred (fever requiring antibiotics); mean hospital
stay was 3,6 days (range 2-13). Patients became normotensive immediately after surgery (mean preoperative blood pressure: 152/93 mmHg; mean postoperative
blood pressure: 120/71 mmHg, respectively). None of the patients required further hypotensive treatment (Table 2).
Aldosterone and plasmatic renin activity (PRA) levels decreased and returned within the normal range after surgery (mean post-operative aldosterone: 152 pg/ml [
normal range: 17.6-232] and mean post-operative PRA:2.4 ng/ml h [range: 0.2–2.8], respectively). At one-yr follow-up, all patients were normotensive and
hypotensive treatment free.


In the era of minimally invasive surgery, partial adrenalectomy has been certainly underused, and adrenal masses are treated through robotic total adrenalectomy [1]. We reported safety and feasibility of robotic partial adrenalectomy for patients with aldosterone-secreting adenomas.


RPA is a safe, feasible and minimally invasive surgical approach. The excellent perioperative and early functional outcomes suggest
an increasing adoption of this technique in the near future.


1. Robotic assisted adrenalectomy: Surgical techniques, feasibility, indications, oncological outcome and safety.
Yiannakopoulou E.
Int J Surg. 2016 Apr;28:169-72. doi: 10.1016/j.ijsu.2016.02.089. Epub 2016 Feb 27. Review