The first laparoscopic endocrine surgery experiences published in the literature were the laparoscopic adre-nalectomies performed by Gagner in 1992 [25]. Currently, the minimally invasive approach is the recommended standard for the treatment of benign adrenal lesions. In Italy in 1999, Piazza and colleagues published the first robotic-assisted adrenalectomy using the Zeus Aesop [26]. One year later, in August 2000, V. B. Kim and colleagues used the da Vinci® Robotic Surgical System to fully assist an adrenalectomy [2]. Our first robotic-assisted bilateral adrenalectomy was published in 2001 [6]. Brunaud and others prospec-tively compared standard laparoscopic adrenalectomy and robotic-assisted adrenalectomy in a group of 28 patients. They found the robotic approach seemed to be longer (111 vs. 83 min, p = 0.057), but this tendency decreased with surgeon experience. The morbidity and the hospital stay were similar for both groups. In addition, duration of standard laparoscopic adrenalec-tomy was positively correlated to patient's BMI. This correlation was absent in patients operated on with the da Vinci® system [27]. Objective benefits of robotic vs.

laparoscopic approach have not been demonstrated yet, but even given the limited experience available, the robotic system seems to be very useful for adrenalectomy in overweight and obese patients.

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