The concept of “insular lobe epilepsy” was first introduced in the 1950s when it was discovered that stimulation of the insula could produce symptoms similar to those of temporal lobe epilepsy, and the similarity in clinical symptoms between the two was very confusing. The cross-regional, multicenter clinical case statistics conducted for many years afterwards also showed that among surgically treated temporal lobe epilepsy patients, about 70% had a good prognosis, but 20% had poor surgical outcome, and 10% had ineffective surgical treatment; and among these ineffective patients, insula involvement may be a key reason for treatment failure in some patients with refractory epilepsy after temporal lobectomy alone. The insula belongs to the limbic system and, as a fifth lobe, it is closely associated with visceral activity and emotional centers and is adjacent to motor, sensory, and language centers. The insula has many different functions, such as memory, drive, emotion and higher autonomic control of taste and smell; tumors in the insula region can induce multi-system dysfunction, and improper diagnosis and treatment can be life-threatening. However, because the insula is part of the limbic system, closely related to visceral activity and emotional centers, and adjacent to motor, sensory, and language centers, surgical resection is likely to damage certain brain functions and tissues of patients and increase the incidence of complications. Low-power bipolar electrocoagulation and thermal cautery is a safer surgical method, i.e., for intractable epilepsy in functional brain areas, bipolar electrocoagulation is applied to perform electrocoagulation and thermal cautery of the epileptogenic lesion cortex under low output power for 1 to 2 seconds to block the horizontal diffusion of epileptic discharges by damaging the superficial layers of the cerebral cortex and reduce cortical excitability to reduce epileptogenic seizures.