title: [Combination of intraoperative ultrasonography for localizing insulinoma under Da Vinci robotic surgical system: experience of a single center in 50 cases].
abstract: OBJECTIVE
  To evaluate the effect and safety of enucleation of insulinoma under the Da Vinci robotic surgical system combination with intraoperative ultrasonography(IOUS) for the localization.
  
  
  METHODS
  The clinical materials of 50 insulinoma cases which underwent IOUS and assisted by the robotic surgical system from September 2012 to September 2014 in Peking Union Medical College Hospital were reviewed retrospectively. The patients were followed up by outpatient review and telephone until October 2014. The diagnostic accuracy rate, operation time, blood loss, complications and cure rate were analyzed by t-test.
  
  
  RESULTS
  The locations of tumors were 13 in the head, 21 in the body and 13 in the tail of pancreas, 2 were multiple insulinoma, 1 was ectopic to mesenterium.The average operation time was 142 minutes; the average blood loss was 165 ml.Three(6.0%) patients were transformed to open.One patient experienced postoperative bleeding about 300 ml on the 7(th) day after operation and no infection and perioperative death.Thirty-five cases were of class A and 14 of class B according to the clinical grading of postoperative pancreatic fistula.The blood glucose 60 minutes after tumor dissection was significantly elevated than that before operation ((6.2±1.8)mmol/L vs.(3.7±1.2)mmol/L)(t=-6.89, P<0.01). The cure rate was 100% as all the patients' symptoms were disappeared during follow-up time.
  
  
  CONCLUSIONS
  Combination IOUS is a highly sensitive method for the localization of insulinoma, which is helpful in localizing tumors precisely in insulinoma cases assisted by robotic surgical system and shortening operation time.It is safe and effective for insulinoma enucleation.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xianlin
authors.initials: X
authors.lastname: Han
authors.forename: Wenming
authors.initials: W
authors.lastname: Wu
authors.forename: Mengyi
authors.initials: M
authors.lastname: Wang
authors.forename: Lin
authors.initials: L
authors.lastname: Cong
authors.forename: Quan
authors.initials: Q
authors.lastname: Liao
authors.forename: Menghua
authors.initials: M
authors.lastname: Dai
authors.forename: Taipin
authors.initials: T
authors.lastname: Zhang
authors.forename: Yupei
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D061646:Operative Time; D010179:Pancreas / Q000000981:diagnostic imaging / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose