Post written by Mihir S. Wagh, MD, FACG, FASGE, from the Division of Gastroenterology, University of Colorado-Denver School of Medicine, Aurora, CO, USA.

We report EUS-guided ablation of symptomatic insulinoma with the newly available EUSRA device. Our video highlights the EUSRA device, the technique used for ablation, and successful clinical, physiologic, and radiologic results after treatment.

The previously available EUS-RFA device was recently taken off the market, and the new device (EUSRA) described in this video has recently become available in the United States. Hence, we would like to share our experience with this device for the management of symptomatic insulinoma. We demonstrate that the EUSRA device is easy to use, safe, and effective.

Previous experiences with endoscopic ablation of pancreatic lesions including alcohol ablation have been associated with mixed results and risk of pancreatitis. However recent advances in RFA technology have significantly improved this modality and ease of use. EUS-RFA represents a less-invasive alternative to operative resection of pancreatic lesions in non-surgical candidates. Long-term efficacy of EUSRA for treatment of solid and cystic pancreatic lesions and risk of adverse events such as pancreatitis and pancreatic leak need to be assessed in future studies. We hope that our report spurs further assessment of this technology and that endoscopists, oncologists, and surgeons consider EUS-RFA in the management of pancreatic neoplasms in select patients.

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