Search

Diseases of the adrenal gland have been treated surgically since the nineteenth century. Since the first planned adrenalectomy by Sargent in 1914 for a large adenoma, various approaches to this operation have been developed. Open techniques have paved the way for less invasive approaches. In 1992, Gagner et al. [1] reported their initial experience with transperitoneal laparoscopic adrenalectomy. Since then, minimally invasive techniques have gained wide adoption, partly due to decreased postoperative pain, lessened morbidity, and quicker patient recovery. The advent of robot-assisted techniques has overcome many of the limitations of traditional laparoscopy. In 2001, Horgan et al. [2] first reported their experience using a da Vinci® robotic system to perform adrenalectomy. Contemporary literature continues to support the use of robot-assisted techniques to treat adrenal pathology [3–6]. When planning for surgeries of the adrenal gland, complete imaging and endocrine workup is warranted to achieve an accurate preoperative clinical diagnosis.

In the United States, the annual incidence of renal cancers is approximately 61,560, and 14,080 die of the disease. The lifetime probability of developing invasive renal cancer is 2% in males and 1.2% in females [1]. Although recent advances in systemic and targeted immunotherapies have improved long-term survival in patients, surgical extirpation still offers the best chance for cure in localized disease. Other treatment approaches such as active surveillance, radiofrequency ablation, and cryotherapy may be appropriate for patients who are unfit for surgery or who have competing comorbidities. Surgical options for renal tumors include partial and radical nephrectomy. Nephron-sparing surgery (NSS), as allowed by the tumor characteristics and patient comorbidities, is the preferred approach for small renal masses. NSS may delay the onset of chronic kidney disease, associated cardiovascular events, and mortality, while providing equivalent oncologic results [2, 3]. Partial nephrectomy has become the standard of care for T1 tumors (≤7 cm in size).