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Updated: Jun 28, 2026

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head

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Minimally Invasive Versus Open Surgery for Insulinoma: A 20-Year Institutional Experience.

Sagar D Patel¹, Ranim Alsaad¹, John L Cameron¹

¹Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association

|June 26, 2026

Summary

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Minimally invasive surgery (MIS) for insulinoma offers improved short-term outcomes, including shorter hospital stays and fewer complications, compared to open surgery. This approach also facilitates parenchymal-sparing techniques while maintaining oncologic control.

Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Endocrinology

Background:

Growing trend towards minimally invasive surgery (MIS) for insulinoma.
Need to compare perioperative and oncologic outcomes of open vs. MIS approaches over a 20-year period.

Purpose of the Study:

To compare short-term perioperative and long-term oncologic outcomes of open versus minimally invasive surgery (MIS) for insulinoma.
Evaluate the effectiveness of MIS in insulinoma resection.

Main Methods:

Retrospective single-institution cohort study.
Analysis of patients who underwent surgical resection for insulinoma between 2004 and 2024.
Grouping patients by surgical approach: open or MIS.

Main Results:

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MIS approach (62.2%) was more common than open approach (37.8%).
MIS was associated with more parenchymal-preserving resections (54.3% vs. 28.6%, p=0.009).
MIS led to shorter length of stay (5.0 vs. 6.5 days, p=0.011), lower 30-day readmission rates (17.4% vs. 42.9%, p=0.034), and no incisional hernias (0% vs. 14.3%, p=0.018).
No significant difference in local recurrence rates (4.3% vs. 3.6%, p=1).

Conclusions:

Minimally invasive surgery (MIS) allows for increased use of parenchymal-sparing techniques in insulinoma resection.
MIS approach improves short-term surgical outcomes without compromising oncologic integrity.
MIS is a viable and effective approach for insulinoma treatment.