Robotic pericardial patch repair of the bronchus intermedius after bronchogenic cyst removal

Bronchogenic cysts are often asymptomatic mediastinal masses that are usually diagnosed as incidental findings. Surgical resection can be performed with robotic surgery, and if repair of the airway is needed, this can be achieved by direct closure or by applying a pericardial patch. We present a case of a 45-year-old woman diagnosed with a mass in the visceral mediastinum. She had undergone resection adopting a 4-armed, completely portal robotic technique. However, the removal of the cyst had led to a large tear in the bronchus intermedius. The bronchus was then repaired with a 2.4-cm-long pericardial patch sutured with the V-lock sutures. The entire procedure was performed in a total span of 189 min, and the patient was discharged on postoperative Day 2. The robotic platform, with articulated instruments, allowed complex suturing while conversion was not required. To our knowledge, the robotic surgery has not been applied in bronchial repairs by pericardial patches, and this case is the first of its kind.