Abstract
Background
Insulinomas are rare insulin-producing pancreatic neuroendocrine tumors leading to severe episodes of hypoglycemia. Surgery is the predominant curative therapy.
Methods
We report here the first pediatric case of an insulinoma of the pancreatic body resected completely robotically under ultrasound guidance in a 10-year-old male with multiple endocrine neoplasia type 1. The port set-up was adapted for the narrowed dimensions of the pediatric peritoneal space. We comment on technical key steps for the organ preserving procedure that was performed in close proximity to critical anatomic structures, with supporting video. Preoperative diagnostics, including endoscopic ultrasound, to determine surgical management are highlighted.
Results
Following an uneventful post-operative course, the boy was discharged on day 11 with normalized glucose-metabolism. A pseudocyst developing after 4 weeks was treated with endoscopic stenting.
Conclusions
The applicability of a robotic surgical system in limited space conditions such as found in the pediatric abdominal cavity, is demonstrated here for pancreatic surgery.
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