Subcostal approach using the single-port robotic system for a giant ganglioneuroma in a child

The patient was an 8-year-old boy (height, 125 cm; body weight, 22.5 kg) who presented with fever. Computed tomography revealed a 10.3 × 7.8 cm mediastinal tumor. The preoperative diagnosis, based on magnetic resonance imaging findings, was suspected gangliocytoma. Tumor resection was planned using the da Vinci SP (Intuitive) (Video 1 and Figure 1, A). The surgery was performed with isolated lung ventilation and carbon dioxide insufflation at 8 mm Hg in the left lateral position. A 4.0-cm skin incision was made in the subcostal area (Figure 1, B) and an S-size access port was used.