Israel Performs Its First Robotic Lung Transplant
In a first for Israel, Beilinson Hospital has performed a robotic lung transplant without fully opening the chest or spreading the ribs. This cutting-edge procedure, still carried out in only a very limited number of medical centers worldwide, marks a major breakthrough in thoracic surgery and opens up new possibilities for patients requiring a lung transplant.
The operation was performed using the da Vinci robotic surgical system. Unlike the traditional technique, which requires a large incision, the division of the breastbone and the spreading of the ribs to access the lungs, the surgeons operated through several small incisions in the chest. The robotic system enabled them to connect the transplanted lung to the patient's blood vessels and airways with a high degree of precision.
A Less Invasive Procedure to Reduce Complications
Lung transplantation is among the most complex procedures in modern surgery. The operation typically lasts between eight and ten hours and traditionally involves a major opening of the chest cavity.
This approach can lead to significant postoperative pain, shallow breathing and difficulties clearing pulmonary secretions. These complications can increase the risk of infection and make recovery particularly long and challenging, sometimes lasting several weeks.
The robotic technique aims to reduce these challenges by using much smaller incisions. By preserving more of the chest's muscular and skeletal structures, it could make breathing easier after surgery, reduce pain and accelerate recovery.
Dr. Yury Peysakhovich, head of thoracic surgery at Beilinson Hospital and the surgeon who led the operation, considers the procedure a turning point for lung transplantation in Israel.
"After decades of relying on the traditional method, which is associated with significant pain and numerous complications, we have managed to introduce a genuine revolution in Israel," he said.
According to him, this technique could become the new standard of care within the next five years.
Extensive Multidisciplinary Preparation
To date, approximately 20 robotic lung transplants are believed to have been performed worldwide. The first took place just three years ago in Spain. The procedure requires extensive preparation, specialized training and expertise in both complex lung transplantation and robotic surgery.
Dr. Shai Fein, head of anesthesiology and operating rooms at the hospital, emphasized that using a robot for an operation of this complexity requires exceptional coordination. The robotic arms limit the medical team's direct access to the patient, making it essential to anticipate every stage of the procedure and any potential emergency.
Preparations included planning for ventilation, monitoring vital signs and managing the patient's hemodynamic status. A dedicated surgical simulation was also conducted. As part of the preparations, the patient was connected in advance to a cardiopulmonary bypass machine to ensure immediate assistance if necessary.
A First Step Toward Robotic Surgery
This breakthrough followed another procedure performed at Beilinson approximately one month earlier. At the time, the medical team carried out a lung transplant using a minimally invasive approach, also without fully opening the chest.
Instead of making the large incision traditionally required, surgeons performed just two small incisions, one above the abdomen and the other in the chest area. This technique helps preserve muscles and nerves while improving postoperative pain management.
Patients can therefore breathe, cough and clear pulmonary secretions more easily. These are essential factors in reducing the risk of pneumonia, infections and other postoperative complications. This initial experience helped pave the way for the robotic transplant performed a month later.
According to Dr. Osnat Livne-Shtraichman, head of Beilinson's Institute of Pulmonology and Allergy, the achievement is above all the result of close teamwork among medical professionals and the hospital's accumulated experience.
Beilinson has performed more than 1,000 lung transplants, allowing it to develop substantial expertise in caring for patients both before and after transplantation.
Recovery Exceeds Expectations
One of the main objectives of this new approach is to significantly reduce postoperative pain, a crucial factor in patients' rehabilitation and recovery.
Dr. Dan Gorfil, head of cardiothoracic intensive care at Beilinson, explained that managing postoperative pain is traditionally one of the biggest challenges following a lung transplant.
However, the recovery of the patient who underwent the robotic procedure exceeded the medical team's expectations. He required very little pain medication beyond paracetamol. This progress helped shorten both his stay in intensive care and his overall hospitalization.
If these results are confirmed in a larger number of patients, the approach could gradually transform lung transplantation practices and significantly improve the quality of life of transplant recipients.
Caroline Haïat
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