Robotic surgery for circumferential tracheal resection and reconstruction has not previously been reported. Herein we describe the case of a 48‐year‐old man with primary extra‐luminal tracheal leiomyosarcoma. A preoperative bronchoscopy exam and chest computed tomography revealed a tracheal neoplasm, which derived from lower membranous trachea and nearly obstructed the orifice of the left main bronchus. The patient underwent circumferential tracheal resection and reconstruction via a completely portal robotic approach with four arms. Benefitting from flexible instruments and a three‐dimensional magnified view, telescope anastomosis was performed and modulated. No postoperative complications presented. Follow‐up showed the reconstructed trachea without stenosis or recurrence.
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