Laparoscopic localization and resection of insulinomas

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Insulinomas are rare pancreatic neuroendocrine tumors causing hypoglycemia.
• Surgical resection is the primary treatment for insulinomas.
• Minimally invasive approaches are increasingly explored for pancreatic surgery.

Purpose of the Study:

• To evaluate the feasibility and safety of laparoscopic localization and resection of insulinomas.
• To assess the impact of laparoscopic resection on patient outcomes, including morbidity and hospitalization.
• To determine the role of intraoperative ultrasound in laparoscopic insulinoma surgery.

Main Methods:

• Retrospective case series of nine patients undergoing attempted laparoscopic insulinoma resection.
• Data collected on preoperative localization, intraoperative findings, complications, and length of hospitalization.
• Laparoscopic intraoperative ultrasonography was utilized for tumor identification.

Main Results:

• Laparoscopic localization and resection were feasible in selected cases.
• Four conversions to open laparotomy were necessary due to localization or safety concerns.
• Intraoperative ultrasound aided lesion identification in 80% of cases where used, with successful laparoscopic resection in three patients.
• Shorter average hospital stay was observed after laparoscopic resection (4.5 days vs. 7.0 days).

Conclusions:

• Laparoscopic localization and resection of insulinomas are feasible and safe procedures.
• Laparoscopic ultrasound is a valuable tool for enhancing insulinoma localization and facilitating resection.
• While preoperative localization is not essential, prior knowledge of tumor location can optimize the surgical approach.
• Laparoscopic insulinoma resection may lead to reduced hospital stay and faster recovery.