Current status of robotic adrenalectomy in the United States.

Since its introduction more than 30 years ago, laparoscopic adrenalectomy has become the gold standard approach to adrenal surgery for the majority of adrenal pathology. It has been shown to have superior clinical benefits to open adrenalectomy for the majority of cases of adrenal surgery. Robot-assisted adrenalectomy has also been shown to be a reasonable alternative approach to adrenal gland resection. Even though robot-assisted adrenalectomy has been performed in the United States for more than 20 years, it has yet to become the gold-standard for this operation, evidenced by the fact that in the United States laparoscopic adrenalectomy remains more common than robot-assisted adrenalectomy. Market factors, clinical factors and surgeon factors all play a role in the spread and adoption of robotic surgery in general. Here we review the most up to date literature on the state of robotic adrenalectomy in the United States, and explore some of the factors that may be influencing the rate of adoption of robotic adrenalectomy in the United States.