Single-Port Robotic Posterior Retroperitoneoscopic Adrenalectomy: Current Perspectives, Technical Considerations, and Future Directions

Abstract

Single-port (SP) robotic posterior retroperitoneoscopic adrenalectomy (SP-PRA) represents a State-of-the-Art innovation in endocrine surgery, offering a minimally invasive approach for adrenal gland resection with significant improvements in surgical precision, cosmetic outcomes, and patient quality of life. The SP robotic system facilitates surgery through a single incision in the back, avoiding the transperitoneal cavity and enabling direct retroperitoneal access to the adrenal gland. This review explores the evolution, techniques, and clinical outcomes of SP-PRA, emphasizing its advantages over traditional multi-port and laparoscopic methods. Enhanced visualization and precise articulation of the SP robotic system minimize trauma to surrounding tissues, leading to fewer complications and faster recovery times. Initial studies suggest superior patient satisfaction due to hidden incisions and excellent postoperative outcomes. However, challenges such as a steep learning curve, high costs, and limited long-term data remain. This review highlights the need for continued research and innovation to optimize the adoption of SP-PRA and expand its indications.

Keywords: minimally invasive surgery; retroperitoneal adrenalectomy; robotic surgery; single-port robotic system.

Figure 1

Skin incision below the lowest tip of the 11th and 12th ribs.

Figure 2

Docking with 3D HD camera and 3 robotic instruments.