Correction of Congenital Hyperinsulinism by Robotic-Assisted Laparoscopy in an Infant

Abstract

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.