Comparative outcomes of laparoscopic vs robotic paraganglioma excision: a tertiary care center experience
Abstract
Background: Paragangliomas are rare neuroendocrine tumors that require complete surgical excision. While laparoscopic surgery has been the minimally invasive standard, robotic-assisted surgery offers potential advantages, including enhanced visualization and articulation. This study compares perioperative outcomes between laparoscopic and robotic approaches for paraganglioma excision.
Methods: A retrospective analysis of 24 consecutive patients who underwent minimally invasive excision of paragangliomas at our tertiary care center between 2015 and 2025 was conducted. Patients were divided into two groups: robotic-assisted (n = 6) and laparoscopic (n = 18) approaches. Demographics, biochemical markers, operative parameters, complications, length of hospital stay, and follow-up outcomes were compared between groups. Statistical analysis was performed using the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables.
Results: The mean age was similar between groups (robotic: 38.3 ± 13.1 years vs. laparoscopic: 39.2 ± 16.7 years, P = 0.97). Operative duration was significantly longer in the robotic group (190.0 ± 31.0 min vs. 143.3 ± 43.1 min, P = 0.021). However, there were no significant differences in length of hospital stay (7.7 ± 1.8 vs. 5.9 ± 3.1 days, P = 0.23) or complication grades (Clavien-Dindo 2.17 ± 0.41 vs. 2.22 ± 0.43, P = 0.81). Both groups achieved 100% biochemical remission at follow-up with complete histopathological excision in all cases.
Conclusions: Both laparoscopic and robotic approaches for paraganglioma excision are safe and effective with comparable perioperative outcomes. While robotic surgery requires longer operative time, it offers an equivalent safety profile and oncological outcomes. The choice of approach may depend on tumor location, complexity, and surgeon experience.
Keywords: Paraganglioma, robotic surgery, laparoscopic surgery, minimally invasive surgery, neuroendocrine tumor, pheochromocytoma