Localization of insulinoma by laparoscopic infragastric inspection of the pancreas and contact ultrasonography

A new technique for localizing pancreatic insulinoma is described. This consists of a laparoscopic examination of the body and tail of the pancreas through an infragastric approach combined with contact ultrasonography of the gland. Accurate localization of an occult insulinoma in the body of the pancreas was achieved in one patient with the technique described. Laparoscopic contact ultrasonography of the pancreas by the infragastric approach should be as reliable as open intraoperative ultrasonography and constitutes the first step in the laparoscopic treatment of insulinoma.