Bronchogenic cyst excision using a robotic laparoscopic transdiaphragmatic approach

Abstract

We describe one case of a bronchopulmonary foregut malformations (BPFM) excision using robotic technology in a pediatric patient. Traditionally, surgical resection is performed using a thoracotomy or video-assisted thoracic surgery. A 12-year-old girl with a previous medical history of cough was diagnosed with a left cystic paracardiac mass. Her operation employed a transdiaphragmatic approach to remove the mass. The postoperative course was uneventful, and she was discharged after four days. The subsequent pathology concluded that the mass was a bronchogenic cyst. To the best of our knowledge, this is the first report of transdiaphragmatic laparoscopic approach and first use of robotics-platform for BPFM excision by children. We elected to use this type of procedure to decrease the postoperative morbidity associated with the thoracic approach. The robotic technology permitted surgical resection with a similar efficiency as standard thoracic or laparoscopic procedures. We hypothesized that this technology would simplify some of the technical points, decreasing any postoperative complications. • This case report describes a transdiaphragmatic approach of a mediastinal lesion • This is the first description of this approach with robotic surgery • Robotic technology allows for an excellent visualization and dissection • It is safe and feasible for small lesions just above the gastroesophageal junction