Beilinson performs Israel's first robot-assisted lung transplant

The operation

Surgeons at Beilinson Hospital in Petah Tikva carried out the operation in October. The team used the da Vinci system through several small incisions. It connected a donor lung to the recipient's blood vessels and airway. Beilinson announced the result on Monday, describing it as a first for the country and saying it places Israel among a select group of countries able to carry out the procedure.

Conventional lung transplantation often requires an extensive chest opening, sometimes involving division of the breastbone or separation of the ribs.

Dr. Yuri Peysakhovich, head of Beilinson's Department of Thoracic Surgery, led the operation. "Robotic lung transplantation is a turning point for lung transplants in Israel," he said.

Why the technique matters

Conventional lung transplantation generally lasts eight to ten hours, and it requires opening the chest. That causes severe postoperative pain and shallow breathing, which makes it harder for patients to cough and clear secretions. The result is a higher risk of infection. Recovery also takes longer, often several weeks. The robotic technique is designed to reduce trauma to the chest wall by working through smaller openings.

Doctors hope that means less pain and easier breathing. They also hope for shorter hospital stays for future patients.

Beilinson reported that its robotic patient needed almost no pain medication beyond paracetamol and spent less time in intensive care and in the hospital overall than the team had expected. Dr. Dan Gurfiel, director of Beilinson's cardiothoracic surgical intensive care unit, said the recovery "exceeded all expectations".

Those are observations from one patient, and the hospital did not provide comparative outcome data. Whether the technique reliably beats conventional surgery across many patients is untested.

The preparation behind it

Dozens of specialists took part. They included surgeons, anesthesiologists, pulmonologists, operating room nurses, intensive care physicians, heart-lung machine operators and tissue-typing laboratory staff.

Dr. Shai Fein directs Beilinson's Anesthesiology and Operating Rooms Division. He said the robotic arms limit direct access to the patient. One of the hardest problems was responding to an emergency while those instruments were inside the patient's chest. The team rehearsed in a dedicated simulation and planned ventilation, monitoring, circulation management and emergency responses. As a precaution, the patient was connected to a cardiopulmonary bypass machine in advance so support would be ready if needed.

About a month earlier, Beilinson had performed a minimally invasive lung transplant. It used two small incisions, one above the abdomen and one in the chest. The hospital said the earlier case gave surgeons experience with the smaller openings before the robotic procedure.

Dr. Osnat Livne-Straichman directs Beilinson's Institute of Pulmonary Diseases and Allergy. She said more than 1,000 lung transplants at the hospital helped make the procedure possible, i24NEWS reported. She credited the multidisciplinary team with bringing the technique to eligible patients in Israel.

Where Israel fits

According to Beilinson, about 20 robotic lung transplants have been performed worldwide, the first in Spain three years ago. The Israeli case places Beilinson among a small number of centers worldwide that have performed the procedure.

What happens next

About 20 procedures worldwide is a thin base for a technique the hospital wants to make standard. Peysakhovich said the team aims to reach that point within five years. Hospital News reported that further procedures, comparative studies and longer-term follow-up will be needed to assess the technique's safety, effectiveness and suitability for different recipients. The stated goal remains the five-year mark: robotic lung transplantation without a large chest opening as standard practice.