Case Study: 1-month-old baby with rare Hyperinsulinism saved by world’s first robotic pancreatic surgery

Rare case study: A 1-month-old baby with rare Hyperinsulinism saved by world's first robotic pancreatic surgery, marking a groundbreaking medical success in infant care. Read on to know how the surgery was carried.

When a life begins in the hospital corridor, most parents decide on cradles and toys to fill the house. But Baby Inaya's [name changed] parents were focused on a surgical schedule that would save their daughter's life. Just 16 days into life, baby Inaya suffered from a rare endocrine condition called Congenital Hyperinsulinism (HI) in which the pancreas produces too much insulin. This causes repeated and dangerous drops in blood sugar. She was treated with robotic surgery, which marked the world's 1st reported robotic local pancreatic resection in a 1-month-old infant, weighing only 4.6 kg.

What Is Congenital Hyperinsulinism? Causes and Risks in Newborns

Every low sugar episode was a silent emergency. Admitted at her birth hospital, Inaya had persistent hypoglycaemia attacks. Despite receiving the highest possible concentrations of intravenous glucose, her blood sugar levels continued to fall to critical levels. With her condition remaining unstable, she was referred to Dr. Kavitha Bhat, Consultant - Pediatric Endocrinology at Manipal Hospital Whitefield, for a second opinion.

Explaining the seriousness of the condition, Dr. Bhat noted, "In newborns, the brain depends almost entirely on sugar for energy. When blood sugar falls repeatedly, the brain doesn't get enough fuel, which can cause permanent damage affecting learning, movement, and development. This damage is often silent and can't be reversed."

Severe Hypoglycaemia in Infants: Why Early Diagnosis Is Critical

While reviewing Inaya's medical records, Dr. Bhat noted that genetic analysis indicated a pattern suggestive of focal congenital hyperinsulinism, a form of the disease that can potentially be cured with surgery. Guided by this insight, the baby girl underwent an advanced functional imaging test called an 18F-DOPA PET/CT scan, an investigation available only at select centres worldwide.

It identified a tiny 0.5 cm (5 mm) focal lesion in the pancreas, the size of a grain, a pea, or a peanut, confirming Dr. Bhat's clinical suspicion. This meant the rest of the pancreas was healthy, and surgery could offer a complete cure (with a 90% cure rate) without the need for lifelong medication for digestion and insulin injections.

Robotic Surgery vs Open Surgery: Why Precision Matters in Newborns

The next big question was how the surgery would be done. Two options were available - traditional open surgery and precision robotic surgery, both of which aim to remove the disease but in different ways. In a newborn baby, open surgery carries a greater risk of removing excess pancreatic tissue, future diabetes, and digestive enzyme insufficiency. Given the precision required, the medical team opted for a robotic-assisted surgical approach, which is exceptionally rare worldwide for babies in this age group.

The procedure was led by Dr. Manjunath Haridas, Consultant Colorectal, GI Surgery and Robotic Surgery along with Dr. Arvind Sabharwal, Consultant - Pediatric Surgery with support from Pediatric Endocrinology, NICU, and Anesthesia teams. As the pancreas procedure is complex and non-reported, intense discussion were held before deciding on robotic surgery, considering the medical expertise and robotic techniques available at the hospital.

Baby Discharged Healthy After 9 Days in NICU

Using high-definition robotic optics, the surgical team precisely dissected and removed the 0.5 cm lesion while preserving the rest of the pancreas. The surgery was uneventful with no blood loss; the baby's blood sugar levels stabilized immediately in the operating room, with no need for further glucose infusion.

"There are very few reports of robotic pancreatic surgery in infants, and none of robotic pancreatic surgery in a one-month-old child. To our knowledge, this is the first such case reported worldwide. The achievement reflects what is possible when technology, expertise, and teamwork come together for the smallest and most vulnerable patients. We have completed more than 800+ robotic surgeries in a span 2 years, and with our expertise growing, we are able to cater to such complex needs of these tiny patients.", said Dr. Manjunath Haridas.

The baby was monitored closely after the surgery as she recovered in the NICU for 9 days. She was discharged with oral feeds and minimal medications for any hypoglycaemia episodes.

Follow TheHealthSite.com for all the latest health news and developments from around the world.