Department of General and Visceral Surgery, Protestant Hospital of Bethel Foundation, University Hospital OWL, Campus Bielefeld Bethel, University of Bielefeld, Bielefeld, Germany.
Department of Internal Medicine and Gastroenterology, Protestant Hospital of Bethel Foundation, University Hospital OWL, Campus Bielefeld Bethel, University of Bielefeld, Bielefeld, Germany.
Int J Med Robot. 2021 Dec;17(6):e2317. doi: 10.1002/rcs.2317. Epub 2021 Aug 11.
Insulinomas are rare insulin-producing pancreatic neuroendocrine tumours leading to severe episodes of hypoglycaemia. Surgery is the predominant curative therapy.
We report here the first paediatric 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 paediatric 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.
Following an uneventful post-operative course, the boy was discharged on day 11 with normalised glucose-metabolism. A pseudocyst developing after 4 weeks was treated with endoscopic stenting.
The applicability of a robotic surgical system in limited space conditions such as found in the paediatric abdominal cavity is demonstrated here for pancreatic surgery.
胰岛素瘤是一种罕见的胰岛细胞神经内分泌肿瘤，可导致严重的低血糖发作。手术是主要的治疗方法。
我们在此报告首例 10 岁男性 1 型多发性内分泌肿瘤患者，在超声引导下完全经机器人切除胰体部胰岛素瘤。端口设置适用于儿科腹膜空间的狭窄尺寸。我们评论了在靠近关键解剖结构的情况下进行的保留器官的手术的技术关键步骤，并提供了相关视频。强调了术前诊断，包括内镜超声检查，以确定手术管理。
术后恢复顺利，男孩于第 11 天出院，血糖代谢正常。4 周后出现假性囊肿，行内镜支架治疗。
在此证明，在儿科腹腔等有限空间条件下，机器人手术系统适用于胰腺手术。
