ABSTRACT Background Obesity poses technical challenges in adrenalectomy. Robotic adrenalectomy (RA) offers advantages over laparoscopic adrenalectomy (LA), but evidence in obese patients remains limited. Methods A meta‐analysis of comparative studies through 2025 assessed perioperative outcomes of RA versus LA, with subgroup analyses by body habitus (obese vs. non‐obese) and surgical approach (lateral transabdominal LT vs. posterior retroperitoneal PR). Primary outcomes included operative time (OT), blood loss (EBL), hospital stay (LOHS), complications, conversion, and mortality. Study quality was evaluated using the Newcastle–Ottawa Scale, and certainty was assessed using the GRADE approach. Results Eight studies (1107 patients) were included. RA was associated with reduced EBL ( p < 0.001) and shorter LOHS ( p < 0.001), with no other significant differences. Subgroup analysis showed shorter LOHS in non‐obese LA patients ( p = 0.03). PR showed a shorter LOHS ( p = 0.001) compared with LT. Conclusions RA provides perioperative benefits, particularly reduced blood loss and shorter hospital stay, without compromising safety.
Abdelsamad et al. (2026) studied this question.