Robotic-assisted approach to esophageal duplication cysts

Duplication cysts are rare congenital anomalies that can occur anywhere along the alimentary tract. Esophageal duplication cysts are intramural lesions that constitute between 0.5% and 2.5% of all esophageal masses. These lesions, when symptomatic, are usually diagnosed in children. Their size and location dictate the clinical presentation. With the increased use of diagnostic imaging, asymptomatic lesions are often times incidentally discovered. They have a characteristic appearance on computed tomography (CT) scans and the diagnosis can be supported with the use of esophagoscopy, endoscopic ultrasound, and an esophagram. Definitive treatment for esophageal duplication cysts is surgical excision. Open surgery has been widely replaced by minimally invasive techniques for the management of benign foregut disease. Both laparoscopy and thoracoscopy have demonstrated to be safe and effective in the excision of esophageal duplication cysts. Recently, the advantages offered by robotic-assisted surgery have gained more attention. The improved ergonomics, visualization and dexterity offered by the robotic platform is of particular interest in esophageal surgery where a precise and meticulous dissection is required. This can be applied to surgery both in the thoracic cavity as well as in the abdomen. Whether a trans-thoracic or trans-abdominal approach is taken, robotic-assisted surgery can be used in the surgical excision of esophageal duplication cysts.