{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:46:16Z","timestamp":1786560376868,"version":"build-2736575974"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Minimally invasive adrenalectomy is a challenging procedure in obese patients. Few recent studies have advocated against robot-assisted adrenalectomy, particularly in obese patients. This study aims to compare operative outcomes between the robotic and laparoscopic adrenalectomy, particularly in obese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed on all consecutive patients undergoing adrenalectomy for benign disease by a single surgeon using either a laparoscopic or robotic approach. Adrenal surgeries for adrenal cancer were excluded. Demographics, operative time, length of hospital stays, estimated blood loss (EBL), and intraoperative and postoperative complications were evaluated. Patients were divided into 2 groups; obese and nonobese. A sub-analysis was performed comparing robotic and laparoscopic approaches in obese and nonobese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 120, 55 (45.83%) were obese (body mass index \u2265 30\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). 14 (25.45%) of the obese patients underwent a laparoscopic approach, and 41 (74.55%) underwent a robotic approach. Operative times were longer in the obese vs. nonobese groups (173.30 \u00b1 72.90\u00a0minutes and 148.20 \u00b1 61.68\u00a0minutes, P = .04) and were associated with less EBL (53.77 \u00b1 82.48 vs. 101.30 \u00b1 122, P = .01). The robotic approach required a longer operative time when compared to the laparoscopic approach (187 \u00b1 72.42\u00a0minutes vs. 126.60 \u00b1 54.55\u00a0minutes, P = .0102) in the obese but was associated with less blood loss (29.02 \u00b1 51.05\u00a0mL vs. 138.30 \u00b1 112.20\u00a0mL, P &lt; .01) and shorter hospital stay (1.73 \u00b1 1.23\u00a0days vs. 3.17 \u00b1 1.27\u00a0days, P &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robot-assisted adrenal surgery is safe in obese patients and appears to be longer; however, it provides improvements in postoperative outcomes, including EBL and shorter hospital stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003134820951498","type":"journal-article","created":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T07:17:26Z","timestamp":1604215046000},"page":"588-594","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Robotic and Laparoscopic Approaches for Adrenal Surgery in Obese Patients"],"prefix":"10.1177","volume":"87","author":[{"given":"Hosam","family":"Shalaby","sequence":"first","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdelgawad","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Omar, MD","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghassan","family":"Zora, MD","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Alawwad","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Alameer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohanad","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, LA, 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