{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T07:58:42Z","timestamp":1773215922177,"version":"3.50.1"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction and importance:<\/jats:title>\n Duodenal leiomyomas are rare, often asymptomatic benign tumors, typically discovered incidentally during surgery. This case highlights a unique leiomyoma found during robotic Single Anastomosis Duodeno-Ileal bypass (SADI), emphasizing the importance of intraoperative adaptability in bariatric surgery.<\/jats:p>\n <\/jats:sec>\n \n Case presentation:<\/jats:title>\n \n A 56-year-old male with a BMI of 56 kg\/m\n 2<\/jats:sup>\n underwent robotic SADI. Despite unremarkable preoperative endoscopy, sutures cut through a thickened duodenal wall during duodeno-ileostomy, revealing a leiomyoma on frozen section biopsy. The duodenum and distal antrum were resected, and the procedure was converted to robotic mini gastric bypass (MGB).\n <\/jats:p>\n <\/jats:sec>\n \n Clinical discussion:<\/jats:title>\n This rare finding underscores the challenge of detecting submucosal lesions preoperatively and the need for rapid intraoperative decision-making. Conversion to MGB achieved 90 % excess weight loss at 1-year follow-up, with no malnutrition or complications, demonstrating effective adaptation.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Surgeons performing robotic bariatric procedures must be prepared to manage unexpected pathology through flexible surgical strategies, ensuring favorable outcomes.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111648","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T20:18:18Z","timestamp":1752610698000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Incidental duodenal leiomyoma discovered during robotic SADI: A case report of surgical adaptation and successful outcome"],"prefix":"10.1097","volume":"133","author":[{"given":"Moaz","family":"Abulfaraj","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"1","key":"R1-139-20260310","first-page":"67","article-title":"Leiomyoma of the duodenum: report of a case and review of the literature","volume":"68","author":"Serour","year":"1977","journal-title":"Am. 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