The impact of body mass and posterior adiposity indices in robotic adrenalectomy.

Patients undergoing transabdominal robotic adrenalectomy had larger nodules, higher BMI, and greater estimated blood loss compared to those undergoing retroperitoneoscopic robotic adrenalectomy.

• 149 patients underwent 98 TA and 51 RP robotic adrenalectomies
• Study population: age 55 years [IQR: 42, 66], 70% female
• Single-institution retrospective cohort study from 5/1/2018 to 6/17/2024
• Operative time, length of stay, and complications were similar between TA and RP approaches

Patients with elevated BMI (≥25) had longer operative times than those with normal BMI (<25).

• Operative time: 129 min [IQR: 107, 156] for elevated BMI vs. 118 min [IQR: 90, 134] for normal BMI (p = 0.045)
• Patients with elevated BMI had similar preoperative characteristics to those with normal BMI
• EBL was similar between elevated and normal BMI groups (5 [5,10] vs. 10 [5,23], p = 0.828)
• Complication rates were similar between groups (15% vs. 5%, p = 0.477)

Patients with elevated BMI had longer length of stay compared to those with normal BMI.

• LOS was statistically longer in elevated BMI patients (1 [1,1] vs. 1 [1,1], p = 0.015)
• Two patients with elevated BMI had an 8-day LOS, which contributed to the difference
• Median LOS values were identical at 1 day for both groups despite statistical significance

BMI weakly correlated with operative time in transabdominal but not retroperitoneoscopic robotic adrenalectomy.

• Among TA patients, BMI correlated weakly with operative time (ρ = 0.320, p < 0.005)
• No significant correlation between BMI and operative time was found among RP patients
• The correlation was described as 'weak' by the authors

Posterior Adiposity Index (PAI) did not correlate with operative time in retroperitoneoscopic robotic adrenalectomy.

• PAI had previously been reported as predictive of operative time in RP adrenalectomy using non-robotic platforms
• PAI had not been previously evaluated with the robotic platform prior to this study
• The study found no correlation between PAI and operative time in RP robotic adrenalectomy