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Revolutionary procedure: Robotic lung transplant without fully opening chest

The new technique significantly improves the chances of success and shortens recovery.

Beilinson Hospital in Petach Tikvah, Oct. 27, 2024. Photo by Tahel Rubin/TPS-IL.
Beilinson Hospital in Petach Tikvah, Oct. 27, 2024. Photo by Tahel Rubin/TPS-IL.

In an Israeli first, surgeons at Beilinson Hospital in Petach Tikvah have performed a lung transplant using a surgical robot, without cutting through the breastbone or spreading the ribs. Only a handful of medical centers worldwide have carried out the procedure.

The operation took place last month. Using the da Vinci robotic system and a few small chest incisions, the surgical team connected the new lung to the recipient’s blood vessels and airways. This avoids the traditional technique, which involves sawing through the breastbone and forcing the ribs apart.

Dr. Yuri Peysakhovich, head of the thoracic surgery department, who led the operation, said the team aims to make robotic surgery without opening the chest the accepted standard within five years.

A lung transplant is a complex procedure lasting about eight to 10 hours. The traditional approach causes severe pain and shallow breathing, and makes it hard for patients to clear secretions. That raises the risk of infection and leads to a recovery that can last weeks. The new technique significantly improves the chances of success and shortens recovery.

Only about 20 robotic lung transplants have been performed worldwide, with the first just three years ago in Spain. The procedure demands extensive preparation and skill, both in complex transplants and in operating the robot. Dozens of staff took part, including surgeons, anesthesiologists, heart-lung machine operators, operating room nurses, pulmonologists, cardiothoracic intensive care staff and a tissue-typing laboratory.

Dr. Shai Fein, director of anesthesia and operating rooms, explained that the robotic arms limit direct access to the patient, so the team planned meticulously. This covered ventilation, monitoring, hemodynamic control and emergency response, and included a dedicated simulation. As a precaution, the patient was connected to a heart-lung machine in advance, allowing an immediate response if needed.

About a month earlier, the hospital performed a preparatory operation, a lung transplant without opening the chest, using just two small incisions, one above the abdomen and one in the chest area. The technique better controls postoperative pain, preserves muscles and nerves, and lets patients breathe, cough and clear their lungs, which sharply reduces the risk of pneumonia and infection. Its success paved the way for the robotic procedure.

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