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Purpose <p>To evaluate the feasibility and outcomes of a day-case robotic adrenalectomy programme implemented within a structured Enhanced Recovery After Surgery (ERAS) framework.</p> Materials and methods <p>A retrospective analysis was conducted of all patients who underwent day-case robotic adrenalectomy between November 2023 and March 2025. Procedures were performed via a transperitoneal approach using the da Vinci Xi<sup>®</sup> system and managed under an ERAS protocol incorporating multimodal analgesia, early mobilisation, and omission of postoperative drains and catheters. A transversus abdominis plane (TAP) block was administered intraoperatively for analgesia. Outcomes included operative metrics, perioperative complications, 30-day readmissions, and patient-reported satisfaction measured by the Evaluation du Vécu de l’Anesthésie Générale (EVAN-G) questionnaire.</p> Results <p>Thirteen patients were included. The median age was 49.0 years (46.0–60.0), and the median BMI was 30.0&#xa0;kg/m² (28.0–36.5). Most patients were male (61.5%, <i>n</i> = 8), all were ASA grade 2, and 69.2% (<i>n</i> = 9) had an ECOG performance status of 0. The median estimated blood loss was 10.0 mL (5.0–10.0) and the median operative time was 56.0&#xa0;min (30.5–75.0&#xa0;min). A history of prior abdominal surgery was present in 38.5% of patients (<i>n</i> = 5). Indications included primary hyperaldosteronism (69.2%, <i>n</i> = 9), androgen-producing tumour (<i>n</i> = 1), RCC metastasis (<i>n</i> = 1), and adrenocortical carcinoma (<i>n</i> = 2). No intraoperative or postoperative complications occurred, no patients required readmission, and the median EVAN-G score was 94 (91–96). On preoperative imaging, the median tumour size was 16.0&#xa0;mm (13.0–26.5&#xa0;mm). Postoperative pathological analysis reported a median adrenal gland size of 63.0&#xa0;mm (50.0–72.5&#xa0;mm) and a median lesion size of 15.0&#xa0;mm (9.0–22.5&#xa0;mm).</p> Conclusion <p>Day-case robotic adrenalectomy performed under an ERAS protocol is safe and well-tolerated in selected patients.</p>

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Day-case robotic adrenalectomy under ERAS protocol: early outcomes from a single-centre experience

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月14日

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  • Alberto Costa Silva,
  • Aishwarya Kaur,
  • Safwaan Adam,
  • Jan Ho,
  • Awanish Shukla,
  • Aziz Gulamhusein

摘要

Purpose

To evaluate the feasibility and outcomes of a day-case robotic adrenalectomy programme implemented within a structured Enhanced Recovery After Surgery (ERAS) framework.

Materials and methods

A retrospective analysis was conducted of all patients who underwent day-case robotic adrenalectomy between November 2023 and March 2025. Procedures were performed via a transperitoneal approach using the da Vinci Xi® system and managed under an ERAS protocol incorporating multimodal analgesia, early mobilisation, and omission of postoperative drains and catheters. A transversus abdominis plane (TAP) block was administered intraoperatively for analgesia. Outcomes included operative metrics, perioperative complications, 30-day readmissions, and patient-reported satisfaction measured by the Evaluation du Vécu de l’Anesthésie Générale (EVAN-G) questionnaire.

Results

Thirteen patients were included. The median age was 49.0 years (46.0–60.0), and the median BMI was 30.0 kg/m² (28.0–36.5). Most patients were male (61.5%, n = 8), all were ASA grade 2, and 69.2% (n = 9) had an ECOG performance status of 0. The median estimated blood loss was 10.0 mL (5.0–10.0) and the median operative time was 56.0 min (30.5–75.0 min). A history of prior abdominal surgery was present in 38.5% of patients (n = 5). Indications included primary hyperaldosteronism (69.2%, n = 9), androgen-producing tumour (n = 1), RCC metastasis (n = 1), and adrenocortical carcinoma (n = 2). No intraoperative or postoperative complications occurred, no patients required readmission, and the median EVAN-G score was 94 (91–96). On preoperative imaging, the median tumour size was 16.0 mm (13.0–26.5 mm). Postoperative pathological analysis reported a median adrenal gland size of 63.0 mm (50.0–72.5 mm) and a median lesion size of 15.0 mm (9.0–22.5 mm).

Conclusion

Day-case robotic adrenalectomy performed under an ERAS protocol is safe and well-tolerated in selected patients.