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Updated: Jun 28, 2026
Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
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.
Background:
There is a growing trend towards using a minimally invasive approach (MIS) for patients with insulinoma. We aim to compare the perioperative and oncologic outcomes of open approach versus MIS over a 20-year period.
Methods:
We conducted a retrospective single institution cohort study of patients who underwent surgical resection for insulinoma between 2004 and 2024. Patients were grouped by surgical approach: open or MIS, and outcomes were analyzed.
Results:
28 patients (37.8%) underwent an open approach, and 46 patients (62.2%) underwent an MIS approach. Parenchymal-preserving approach was more commonly done in the MIS group (54.3% vs. 28.6%, p = 0.009). Resection done by a MIS approach was associated with shorter length of stay (5.0 vs. 6.5 days, p = 0.011), fewer grade III/IV surgical complications (19.6% vs. 32.1%, p = 0.15), lower 30-day readmission rates (17.4% vs. 42.9%, p = 0.034), and no cases of incisional hernia (0% vs. 14.3%%, p = 0.018) within two years post-operatively. The difference in local recurrence rates was not statistically significant (4.3% vs. 3.6%, p = 1).
Discussion:
Our experience highlights that an MIS approach allows for greater use of parenchymal-sparing techniques and improved short-term outcomes while maintaining oncologic integrity.
