Surgery for adrenal gland disease. Experience of a tertiary center.

Introduction: Laparoscopic adrenalectomy and robotic adrenalectomy are increasingly accepted methods for removing adrenal lesions, especially for benign conditions. This study investigated the evolution of surgical techniques and patient characteristics at a tertiary centre during the transition from open to minimally invasive surgery. Patients and methods: The analysis included all adrenal surgery cases referred to our institution between January 2009 and June 2025. The following were recorded for each patient: demographics, diagnosis, surgical approach, intraoperative blood loss, histology, length of hospital stays, and complications. Results: A total of 292 adrenalectomies were performed (56% female; mean age 54.5 ± 12.6 years). The left adrenal was more frequently affected (59%), and the mean tumor size was 46.8 ± 25.1 mm. Indications included primary hyperaldosteronism (37%), Cushing's syndrome (28%), pheochromocytoma (15%), adrenal cysts or myelolipomas (17%), adrenocortical carcinomas (4%), and adrenal metastases (2%). Laparoscopy was the most common approach (76%), followed by open (10%) and robotic adrenalectomy (9%); overall 7 (2%) patients required conversion to open surgery and postoperative morbidity was 7%. Minimally invasive procedures were associated with shorter operative times, less blood loss, and shorter in-hospital stays when compared to open surgery ( Conclusions: Minimally invasive adrenalectomy is safe and effective for adrenal tumors. In our series, robotic-assisted surgery is becoming increasingly prevalent and has excellent results; however, its implementation needs to be balanced with the associated costs.