Subcostal single-port robot-assisted resection of a posterior mediastinal tumor in an infant.
Teruhisa Kawaguchi, Fumiaki Watanabe, Shinji Kaneda et al.
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Case in brief
A 6-month-old female infant weighing 5.46 kg underwent resection of a 7.0-cm cystic posterior mediastinal tumor. Surgeons used a subcostal approach with the da Vinci Single Port system, creating a 3.5-cm incision and securing the access port without manipulating the ribs. The operative field was maintained with CO₂ insufflation at 3 mmHg. The tumor was successfully resected, with a total operative time of 132 min.
What made this case unusual
The report describes single-port robotic resection in an infant weighing less than 8 kg, using a subcostal route to limit instrument collision in the small thoracic cavity while avoiding intercostal rib manipulation.
Diagnostic / clinical pearl
In this case, a subcostal single-port approach enabled robotic resection of a large posterior mediastinal cystic tumor in a very small infant without intercostal rib manipulation.
Why it matters
The authors suggest that avoiding intercostal access may reduce intercostal nerve injury and later musculoskeletal complications; this case supports the approach as a potentially feasible minimally invasive option in infants under 8 kg.