Single Incision Robotic Adrenalectomy

Lawrence E Tabone, MD, Chan Park, MD, Dana Portenier, MD


1. Objective of the technology or device

Improve cosmesis in robotic surgery with the use of a single incision port for access to the abdomen. To overcome the difficulties experienced in single incision surgery including awkward operator hand placement and paradoxical instrument motion with the use of the da Vinci Surgical System. Techniques for single incision robotic cholecystectomies have been described in the literature. Our objective was to expand this technology and technique for single incision robotic adrenalectomy. We believe this to be the first documented case of a single incision robotic adrenalectomy.

2. Description of the technology and method of its use or application.
We used an Applied Medical GelPoint Advanced Access Platform to gain access to the abdomen from a single four centimeter supraumbilical incision. Through this single access point we were able to place four trocars. We used the da Vinci Surgical System to perform a robotic adrenalectomy with this single incision platform.

3. Preliminary results if available.
The patient did well postoperatively and was discharged home on post-operative day number one. When seen back in clinic two weeks later she had healed her single incision well with good cosmetic results.
We found the use of the robot with a single incision platform very helpful in overcoming the challenges that are often encounter in single access surgery including awkward operator hand placement and paradoxical instrument motion.

4. Conclusion / future directions.
A single incision port is easily combined with the robotic platform to encompass the superior cosmetic results of a single incision with the function and utility of the robot. We were able to easily complete a single incision robotic adrenalectomy without significant alterations in the standard robotic or laparoscopic approach. We anticipate the increase use of single incision ports with the use of the robot. We have used a similar technique for appendectomy, cholecystectomy, and gastric banding.

Session: Poster Presentation

Program Number: ETP055

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