Robotic-Assisted Resection of a Giant Mesenteric Lymphangioma in a 36-Year-Old Woman: A Case Report

We report a case of a 36-year-old woman who presented with acute abdominal pain and repeated episodes of nonbilious vomiting. Contrast-enhanced computed tomography demonstrated a large, multiloculated cystic lesion measuring approximately 15 × 10 × 8 cm within the small bowel mesentery, without solid components or radiologic features suggestive of malignancy. Because of the patient's symptoms, lesion size, and close relationship to mesenteric vessels, robotic-assisted resection was performed with adjunctive indocyanine green (ICG) fluorescence imaging to facilitate intraoperative vascular assessment and confirm bowel perfusion. Intraoperatively, a giant, translucent cystic mass arising from the jejunal mesentery was identified and completely excised without rupture or bowel resection. Histopathologic examination showed dilated lymphatic spaces lined by flattened endothelial cells within fibrous septa containing lymphoid aggregates, consistent with cystic lymphangioma. The postoperative course was uneventful, and the patient was discharged on the first postoperative day. At the six-month follow-up, she remained asymptomatic with no evidence of recurrence on ultrasonography. This case supports robotic-assisted excision as a feasible, minimally invasive option for selected giant mesenteric lymphangiomas in adults.