Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Δευτέρα 26 Ιουλίου 2021

Technical aspects of pediatric robotic pancreatic enucleation based on a case of an insulinoma

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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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