The role of robot-assisted adrenalectomy for large pheochromocytoma pressing inferior vena cava or extending to retrovena cava space.

e15637 Background: To evaluate the efficacy and safety of robot-assisted laparoscopic adrenalectomy(RALA) for large pheochromocytoma pressing inferior vena cava or extending to retrovena cava space. Methods: From September 2009 to December 2014, 15 RALA were performed on patients with pheochromocytoma pressing inferior vena cava or extending to retrovena cava space. The mean tumor size was 7.6cm (range: 5-11). The preoperative Imaging data suggested that all the tumors compressed the inferior vena cava. The mean age of the patients was 32 yr, and the mean body mass index was 26.5. Positioning and port placement is designed for adequate reach and visualization of the upper retroperitoneum. The tumor is dissected away carefully from both the inferior vena cava and normal adrenal cortex, preserving normal adrenal tissue. Results: All the 15 cases were completed robotically. The mean operative time was 65 min (range: 60-130), the median estimated blood loss was 95 ml (range: 50-250), There was no conversion to an open procedure. At a median follow-up of 12.3 mo (range: 6–38), there were no recurrences or metastatic events. Conclusions: RALA for the treatment of large pheochromocytoma pressing vena cava or extending to retrovena cava space is feasible and safe and provides encouraging functional and oncologic outcomes. However, if local invasion is detected by the preoperative imaging studies, robotic surgery is no longer a preferred option.