An Irish experience of robotic adrenalectomy: Transitioning from open to robotic surgery

BACKGROUND: Minimally invasive techniques have become the gold-standard for the surgical management of the majority adrenal pathologies. No consensus exists over the benefit of robotic over laparoscopic adrenalectomy. The aim of the study was to analyse the authors' experience of adrenalectomy with emphasis on its transition to robotic approaches. METHODS: Retrospective data were collated from a prospectively maintained database of all consecutive adult patients undergoing adrenalectomy at the study centre between 1st January 2015 to 1st June 2025. RESULTS: 61 adrenalectomies were included in the study at a median patient age of 54 years (IQR 43-67). 34% of these were for phaeochromocytoma. Open approaches prevailed at the start of the study but over-all, half the cases were performed robotically. Mean operative time reduced over the study period from 264 min in 2015 to 108 min in 2025. Median length of stay (LOS) was 5 days (IQR 4-7). CONCLUSION: This case series reflects a change in approach to adrenalectomy. The 10-year period demonstrated a marked transition to robotic adrenalectomy, paralleled by rising case volumes and significant improvements in length of stay, operative time, and blood loss. While the overall improvements are likely multifactorial (learning curve effects, increasing institutional experience, evolving case selection, and rising case volumes)-this study demonstrates the safety and feasibility of robotic adrenalectomy.