This video depicts a 40 year old woman with an insulinoma. The patient's preoperative work-up, intraoperative management, and postoperative appearance are depicted, together with pertinent imaging tests. The patient sustained a major complication of this surgery (pancreatic fistula). The management and radiographic work-up of the pancreatic fistula is emphasized as well. Postoperative follow-up (up to 1 year) is provided, documenting an excellent final result. Many posed views are shown, providing an unusually good view of the surgical field. Technical points of importance to practicing surgeons are emphasized.