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Correction of Congenital Hyperinsulinism by Robotic-Assisted Laparoscopy in an Infant
Wellen Cristina Canesin1, Raphael Del Roio Liberatore Junior2, Alberto Facury Gaspar1
1Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo - USP, Ribeirão Preto, SP, Brazil. (Drs. Canesin, Gaspar, Volpe, Leite, dos Santos, and Sbragia).
Insights
Robotic-assisted laparoscopy (RAL) successfully treated congenital hyperinsulinism (CHI) in an infant under 10kg. This minimally invasive approach, near-total pancreatectomy (NTP) by RAL, is a novel technique for pediatric pancreatic surgery.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Endocrinology
Background:
- Congenital hyperinsulinism (CHI) is a genetic disorder causing persistent hypoglycemia in infants due to dysregulated insulin secretion.
- Near-total pancreatectomy (NTP) is the preferred surgical treatment for CHI.
- Minimally invasive surgical techniques are increasingly adopted for pediatric pancreatic conditions.
Background:
Congenital hyperinsulinism (CHI) is a heterogeneous genetic disease characterized by increased insulin secretion, in which dysregulation of insulin secretion by pancreatic β cells causes persistent hypoglycemia in neonates and infants. Babies diagnosed with CHI require preferentially minimal invasive surgical treatment with near-total pancreatectomy (NTP).
Material And Methods:
CHI was treated with robotic-assisted laparoscopy (RAL).
Results:
The authors present an unreported case of CHI in an infant less than 10 kg, which was submitted to NTP treated by RAL. The procedure was performed with 3 arms of Da Vinci robot using adaptable size of trocars and the surgery was well succeeded.
Conclusions:
The RAL is a challenge in pediatric pancreatic surgery to CHI due to the size of the trocars. To our knowledge, this is the first case reported in the English literature of an infant weighing less than 10 kg having been submitted to NTP by RAL.
