Robotic-assisted single-port choledochal cyst radical surgery in children - a case series study.

Background: We pioneered the use of the da Vinci Xi system's robotic-assisted single-port technology for pediatric choledochal cyst resection. We assessed the feasibility and safety of this new surgical approach. Methods: Our study included five pediatric patients diagnosed with choledochal cyst. We described the surgical procedures in detail. We established the single port through the umbilicus. The jejunal Roux limb and intestinal anastomosis were performed outside the abdomen through the single port. Then, we removed the gallbladder and cyst and performed biliary-intestinal anastomosis using the robotic system. We collected characteristic data and perioperative data. Results: All surgeries were successful. The total operative time ranged from 180 to 232 minutes, and the robotic operative time ranged from 60 to 90 minutes. The fasting time ranged from 3 to 7 days, and the hospitalization time ranged from 7 to 14 days. We did not observe any complications, including blood vessel, intestine, or pancreas injury, intra-abdominal or wound infection, cholangitis, or biliary fistula. Conclusion: The robotic-assisted single-port technology is safe and effective for pediatric choledochal cyst resection using the da Vinci Xi system. However, further studies with larger patient populations are needed to provide more information on long-term complications and the learning curve.