Israeli surgeons perform pioneering robotic-assisted lung transplant without traditional chest opening

Surgeons at Beilinson Hospital in Israel have performed the country’s first robotic-assisted lung transplant using small incisions instead of the extensive chest opening traditionally associated with the procedure.

The operation, carried out in October at Beilinson Hospital in Petah Tikva, used the da Vinci robotic surgical system to connect a transplanted lung to the recipient’s blood vessels and airway.

The procedure places the hospital among a small number of medical centres worldwide to have performed robotic-assisted lung transplantation. According to the hospital, approximately 20 such procedures have been performed globally.

A less invasive approach to complex surgery

Traditional lung transplantation often requires surgeons to open the chest extensively to access the lungs, sometimes involving division of the breastbone or separation of the ribs.

Although the procedure can be lifesaving, the surgical approach can cause substantial postoperative pain and make breathing, coughing and clearing lung secretions difficult during recovery.

The robotic-assisted technique is designed to reduce trauma to the chest wall by allowing surgeons to operate through smaller incisions.

Using robotic instruments, the surgical team completed the delicate connections between the donor lung and the recipient’s blood vessels and airway.

The operation was led by Dr. Yuri Peysakhovich, head of thoracic surgery at Beilinson Hospital.

Hospital officials described the achievement as an important step toward making less invasive lung transplantation available to selected patients.

Encouraging early recovery

According to the hospital, the patient experienced a favourable early recovery following the procedure.

Dr. Dan Gorfil, director of the hospital’s cardiothoracic surgical intensive care unit, reported that the patient required very little pain medication beyond paracetamol.

The hospital also reported a shorter intensive care stay and overall hospitalization than the team had anticipated.

These observations are encouraging, although the experience of one patient cannot establish whether robotic-assisted lung transplantation consistently produces better outcomes than conventional surgery.

Further procedures, comparative studies and longer-term follow-up will be needed to assess the technique’s safety, effectiveness and suitability for different transplant recipients.

Extensive preparation and teamwork

The operation required months of preparation and coordination among numerous hospital departments.

The multidisciplinary team included thoracic surgeons, anesthesiologists, operating room nurses, pulmonologists, cardiopulmonary bypass specialists, intensive care professionals and laboratory personnel.

One of the major challenges involved maintaining patient safety while robotic instruments occupied the surgical field, potentially limiting immediate physical access to the patient.

To prepare, the team conducted a dedicated simulation exercise and developed detailed plans for ventilation, circulation monitoring and emergency intervention.

As an additional precaution, the patient was connected to cardiopulmonary bypass equipment before the procedure, allowing the team to provide immediate support if required.

Building on earlier experience

The robotic transplant followed another minimally invasive lung transplant performed at Beilinson approximately one month earlier.

That operation used two small incisions rather than the extensive opening associated with conventional transplantation.

The earlier procedure helped the surgical team develop experience with less invasive access to the chest before undertaking the more technically demanding robotic operation.

Beilinson Hospital has extensive experience in lung transplantation, having performed more than 1,000 lung transplants.

Hospital officials say that experience, combined with specialized robotic training and multidisciplinary planning, was essential to introducing the new technique.

Potential implications for transplant surgery

Robotic-assisted surgery has become increasingly established in several surgical specialties, but lung transplantation remains a particularly demanding application because of the complexity of connecting major blood vessels and airways.

The Beilinson procedure illustrates how robotic technology may expand the possibilities for minimally invasive surgery in highly specialized hospital programs.

For eligible patients, reducing surgical trauma could potentially improve comfort, breathing and mobility during the early recovery period.

However, robotic lung transplantation remains uncommon, and its broader clinical role has not yet been established.

As more hospitals gain experience with the technique, research will be needed to determine which patients may benefit most and whether improvements in recovery can be demonstrated consistently.

The Israeli procedure represents an important technical milestone in the continuing development of transplant surgery.

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