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Many centers around the world are now developing robotic surgical programs. The benefit of robotics, particularly in those centers where there is already expertise with minimally invasive surgical techniques, is unclear. We present the case of a 58-year-old man presenting with an esophageal cyst. This was removed using a robotic assisted, VATS (video assisted thoracic surgery) approach. The technical details of the procedure are described. Additionally, a discussion of the relative merits of using a robotic rather than a standard minimally invasive approach is discussed. In a procedure such as the case described, the critical parts of the procedure are focused within a small operative field. We believe that the articulating instrumentation and the 3-dimensional magnified view provided by the robot offers significant advantages over a standard VATS approach.

The surgical management of the aortic arch pathologies is still subject to discussion. Primary end-to-end anastomosis has some complications such as bronchial compression, tension in the suture lines, and probability of recurrence. On the other hand, patch aortoplasties combined with end-to-end anastomosis carry the risk of aneurysm formation and recurrence. Considering the growth potential, pulmonary autograft patch use in aortic arch reconstructions has recently been introduced into clinical practice. In this study, we present the early findings of combined end-to-end anastomosis and pulmonary autograft patchplasty procedure in six patients. According to our experience the technique applied in this report seems to be more advantageous than other conventional approaches.

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