Robotic-Assisted Total Gastrectomy for Refractory Hypoproteinemia in Menetrier's Disease: A Case Report with Operative Video and Literature Review

Lang Wang^*Ziping LiuJing ZhangXianglin ZhuZhao ShijunCheng ZhaoHao LiangJie ZhangTian GaoYinlu Ding^*

• The Second Hospital of Shandong University, Jinan, China

Ménétrier's disease is a rare, progressive disorder of unclear etiology, typically affecting middle-aged men and characterized by giant gastric mucosal folds, mainly in the fundus and body, with occasional antral involvement. Diagnosis is challenging due to its rarity and the need to differentiate from hypertrophic lymphocytic gastritis, Zollinger-Ellison syndrome, gastric cancer, and lymphoma. We report a young male with Menetrier's disease presenting as generalized edema due to hypoproteinemia. After a challenging diagnostic process and ineffective medical management, the patient underwent robot-assisted total gastrectomy with Roux-en-Y esophagojejunostomy, which corrected the hypoproteinemia. He recovered uneventfully and was discharged on postoperative day 12. At 23 months post-surgery, he showed no hypoalbuminemia, edema, or related symptoms; body weight and serum albumin remained normal. Robot-assisted total gastrectomy is a surgical method for treating Meniere's disease; however, its cost-effectiveness should be carefully considered, and in the long term, more high-quality studies may be required to validate its feasibility.