**4.4 Pancreatic pathology**

There are very few publications of pancreatic pathology in children treated with RAS, we find only case reports about: tumor enucleation, distal pancreatectomy, subtotal pancreatectomy, and pancreaticoduodenectomy. The traditional open surgeries have been largely replaced by MIS, including laparoscopic surgery and RAS.

RAS distal spleen-sparing pancreatectomy is safe and feasible in pediatric patients with insulinoma [119]. Also, robotic enucleation is indicated in small neuroendocrine tumors of the pancreas. This technique provides the dual benefits of minimal invasiveness and good preservation of the pancreatic parenchyma. The experience has demonstrated the feasibility and safety of the RAS enucleation, with an excellent curative effect for pediatric insulinoma [120, 121].
