Robotic-assisted segmental duodenectomy for giant Brunner’s gland hamartoma

ABSTRACT: Brunner's gland hamartoma (BGH) is an extremely rare benign duodenal tumour (<0.01% incidence), often asymptomatic but occasionally presenting with dyspepsia, bleeding or obstruction. Small lesions can be managed endoscopically, whereas broad-based masses require surgical resection. We report the first video article describing robotic-assisted segmental duodenectomy for a giant BGH. A male in his early 40s presented with dyspepsia and intermittent melena with anaemia. Endoscopy and contrast-enhanced computed tomography revealed a 7-cm broad-based lesion arising from the first part of the duodenum, provisionally diagnosed with gastrointestinal stromal tumours. Robotic segmental duodenectomy with stapled antecolic loop gastrojejunostomy was performed using the da Vinci Xi system. Operative time was 156 min with negligible blood loss. Histopathology confirmed BGH. Recovery was uneventful and the patient remained symptom-free at 2 months. Robotic segmental duodenectomy is safe, feasible and ensures adequate margins with enhanced recovery.