Robotic Choledochal Cyst Excision with Intracorporeal Reconstruction: How I Do It

Abstract Choledochal cyst (CDC) is a congenital disorder involving dilatation of the biliary tree with or without the presence of an anomalous pancreatico-biliary ductal union, more commonly observed in children. Individuals with CDC may remain asymptomatic, have dull abdominal pain, or present with complications such as cystolithiasis, cholangitis, pancreatitis, cirrhosis with portal hypertension, and rarely malignancy. The treatment of choice is complete excision of the CDC with bilio-enteric anastomosis. Most commonly, Roux-En Y hepaticojejunostomy is performed for reconstruction. Traditionally, open surgery was performed for CDC excision, but with the advancement in technology and surgeon skills and expertise, minimally invasive surgery has been increasingly adopted to perform this procedure. In the past decade, the robotic platform has been safely and successfully used to perform CDC excision with intra or extracorporeal reconstruction, and the reports highlight its distinct advantages over laparoscopy. In this study, we describe our technique of robotic CDC excision with intracorporeal reconstruction.