V866: Robotic assisted left adrenalectomy with excision of retroperitoneal mass for recurrent renal cell carcinoma

Video

Introduction and Objectives
Renal cell carcinoma has an incidence of solitary adrenal metastasis of 3% in the ipsilateral gland after radical nephrectomy. A wide spectrum of robotic-assisted procedures has been described so far. Herein we show the application of the robotic platform in case of left adrenalectomy with excision of retroperitoneal mass for recurrent renal cell carcinoma.

Methods
A 66 year old male with history of left radical nephrectomy for renal cell carcinoma presented with recurrence in ipsilateral adrenal gland. CT showed multilobulated soft tissue mass in the left renal bed which has merged with nodule in the left adrenal gland. This patient was scheduled for robotic-assisted left adrenalectomy with excision of retroperitoneal mass at our institution._x000D_ The procedure is described in the following video.

Results
The operation was successfully completed without any complications. Operative time was 240 minutes with an estimated blood loss of 200 ml. Foley was removed on day 1 post-op, and the JP was removed on day 2 post-op. Hospital stay was 2 days_x000D_ Pathological report revealed metastatic renal cell carcinoma, papillary type, extensively involving the adrenal gland and surrounding fibroadipose tissue. All surgical margins were free of malignant extension.

Conclusions
Robotic-assisted left adrenalectomy is a safe and effective approach in case of recurrent renal cell carcinoma in ipsilateral adrenal gland after radical nephrectomy.

Funding: none