Single-port robotic resection of a superior mediastinal bronchogenic cyst in a 6-year-old child using the da Vinci SP system: a case report

Background: Bronchogenic cysts often require surgical excision in children because of the risk of progressive enlargement and complications. Although minimally invasive surgery is preferred, pediatric thoracic procedures remain technically challenging because of limited intrathoracic working space. Case Description: A 6-year-old girl with an asymptomatic mediastinal mass demonstrated interval growth of a cystic lesion in the right superior mediastinum on serial imaging. Single-port robotic resection was performed using the da Vinci SP system through a single intercostal incision with low-pressure carbon dioxide insufflation. The cyst was completely excised without rupture or complications. The postoperative course was uneventful, and histopathology confirmed a bronchogenic cyst. Conclusions: This case demonstrates that single-port robotic resection using the da Vinci SP system is feasible and safe when adequate working distance and floating docking are secured in a pediatric patient. The single-port approach may offer technical advantages in anatomically constrained pediatric thoracic cavities. This report provides practical technical insights for applying the da Vinci SP platform in confined pediatric thoracic cavities, where conventional thoracoscopic or multi-port robotic approaches may be limited.