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Hamad et al. Mini-invasive Surg 2023;7:16 https://dx.doi.org/10.20517/2574-1225.2023.03 Page 7 of 10

Table 2. Published literature comparing robotic choledochal cyst resections to laparoscopic and open choledochal cyst resections
Year Author Publication type Choledochal cyst type Sample size
2015 Margonis et al. [30] Retrospective I, II, III, IV 368 (O: 332, MIS: 36)
[33]
2018 Lee et al. Retrospective Ia, Ib, Ic, II, III, IVa, IVb 67 (L: 49, R: 18)
[34]
2018 Han et al. Retrospective Ia, Ib, Ic, IVa, IVb 67 (L: 47, R: 22)
[35]
2021 Yoon et al. Retrospective I, II 39 (L: 23, R: 16)
[36]
2022 Morikawa et al. Retrospective Ia, Ic, IVa 36 (O: 16, L: 15, R: 5)
2022 Zhang et al. [20] Systematic review and meta-analysis Ia, Ib, Ic, II, III, IVa, IVb 173 (L: 119, R: 56)
L: Laparoscopic; MIS: minimally invasive surgery; O: open; R: robotic.

Figure 5. (A, B, and C) Robotic hepaticojejunostomy anastomosis (arrow) after choledochal cyst resection.

increase in the amount of routinely used drugs, combined with an increase in the volume of laparoscopic
surgery over time. Morikawa and colleagues compared 36 patients undergoing open, laparoscopic, and
robotic resections. Higher operative times were again associated with the MIS approach, yet there was
shorter hospital LOS, lower EBL, and lower rates of internal stents. Among patients undergoing an MIS
approach, the RCCR cohort had shorter operative times during the HJ anastomosis portion of the surgery
compared to LCCR.