Minimally invasive or minimally invasive assisted (MIS) choledochal cyst excision has been an area of exploration and interest since Farello et al. described the first laparoscopic assisted excision of a choledochal cyst in 1995.1 Despite the overall growth of laparoscopic surgery within the field of pediatric general surgery, the treatment of choledochal cysts with minimally invasive techniques has not gained widespread acceptance. Laparoscopic excision of choledochal cyst with Roux en Y hepaticojejunostomy has been shown to have several advantages over open surgery including decreased blood loss and length of stay.2 However, the technically demanding nature of the hepaticojejunostomy as well as dissection in the porta with traditional laparoscopic instruments and 2-dimensional cameras may be at least partially driving the slow adoption of these techniques.

Since Woo et al described the first robotic assisted resection of a choledochal cyst with Roux en Y hepaticojejunostomy in 2006, there has been increased interest in applying this new technology to this operation.3 Indeed, some surgeons have documented their reticence to attempt complex hepatobiliary surgery using traditional laparoscopic techniques, while describing the advantages of the DaVinci surgical robot (Intuitive Surgical, Sunnyvale CA) for the operative treatment of choledochal cysts and biliary atresia.4