First report of robotic-assisted partial gastrectomy of a large lymphatic-venous malformation in a teenager: A case report

Introduction: Gastrointestinal vascular anomalies are rare in children. A subtype, lymphatic-venous malformations, is even rarer. These anomalies can result in serious sequelae such as bleeding. Management of these rare pathologies is challenging and may involve endoscopic, angiographic, or surgical management. Case Report: We present the case of a 14-year-old female who presented to the hospital after hematemesis and was found to have a gastric vascular malformation. Workup included cross-sectional imaging, endoscopy, and angiography. After multidisciplinary discussion, definitive management was achieved with a robotic-assisted partial gastrectomy with longitudinal gastric closure. The surgical pathology was diagnostic of a lymphatic-venous malformation. No complications occurred in the perioperative period through 10 months of follow-up. Conclusion: This is the first report of a robotic-assisted partial gastrectomy with supplemental use of indocyanine green and endoscopy for gastric lymphatic-venous malformation. Use of the robotic platform for minimally invasive resection is safe and can be considered for management of this rare pathology. Keywords: Gastric lymphatic-venous malformation, Pediatric indocyanine green, Pediatric robotic-assisted partial gastrectomy, Pediatric vascular malformation