Robotic versus laparoscopic surgery for sporadic benign insulinoma: Short- and long-term outcomes

• Published in: Hepatobiliary & pancreatic diseases international Vol. 23; no. 4; pp. 399 - 405
• Main Authors: Yin, Zhu-Zeng, Gao, Yuan-Xing, Zhao, Zhi-Ming, Hu, Ming-Gen, Tang, Wen-Bo, Liu, Rong
• Format: Journal Article
• Language: English
• Published: Singapore 01-08-2024
• Subjects: Adult; Female; Humans; Insulinoma - surgery; Laparoscopy - adverse effects; Laparoscopy - methods; Length of Stay; Male; Middle Aged; Operative Time; Pancreatectomy - adverse effects; Pancreatectomy - methods; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - methods; Time Factors; Treatment Outcome; Enucleation; Laparoscopy; Robotic surgical procedures; Insulinoma; Pancreatectomy
• ISSN: 1499-3872
• DOI: 10.1016/j.hbpd.2023.06.012

Minimally invasive surgery is the optimal treatment for insulinoma. The present study aimed to compare short- and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.
A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted. The demographic, perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.
A total of 85 patients were enrolled, including 36 with laparoscopic approach and 49 with robotic approach. Enucleation was the preferred surgical procedure. Fifty-nine patients (69.4%) underwent enucleation; among them, 26 and 33 patients underwent laparoscopic and robotic surgery, respectively. Robotic enucleation had a lower conversion rate to laparotomy (0 vs. 19.2%, P = 0.013), shorter operative time (102.0 vs. 145.5 min, P = 0.008) and shorter postoperative hospital stay (6.0 vs. 8.5 d, P = 0.002) than laparoscopic enucleation. There were no differences between the groups in terms of intraoperative blood loss, the rates of postoperative pancreatic fistula and complications. After a median follow-up of 65 months, two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.
Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time, which might lead to a reduction in postoperative hospital stay.