Annually, around 4,600 lung transplants are conducted globally. While robots are frequently utilized in various surgeries, their use in lung transplants has been uncommon. Although robotic assistance has enhanced lung cancer surgeries by making them minimally invasive, lung transplant recipients still undergo more invasive surgical procedures. However, advancements in robotic technology are now being extended into the field of lung transplants.

In February 2023, a team of surgeons at Vall d'Hebron University Hospital (Barcelona, Spain) successfully performed Spain’s first robotically assisted single-lung transplant and followed with a second operation three months later. Both patients exhibited significant improvement during their recovery, requiring only mild pain management, a testament to the less invasive nature of the surgery. The primary aim was to minimize the surgical incision and reduce the need for strong pain medication, which can adversely affect wound healing. Extensive preparatory work was done by the surgical team, including practice on synthetic lungs and large animal models, to refine their technique. They discovered that by deflating the lung and utilizing the natural elasticity of the skin, it was possible to make smaller incisions below the sternum for both removing and inserting the lungs.

Following these successful procedures, the team is collaborating with a medical device company to develop robotic instruments tailored for lung transplantation. Their future objectives include performing a bilateral lung transplant and increasing the number of robotically assisted surgeries to five this year and ten in the next. They are also keen on disseminating this innovative technique to more lung transplant programs. The team believes that less invasive surgery will yield better outcomes for lung transplant patients, although more data are needed to validate this approach. Additionally, further enhancements in robotic technology are required before it can be routinely adopted for lung transplantation.

“Lung transplants are a very tough procedure, from donor selection through the surgery to the postoperative period,” said Albert Jauregui, MD, PhD, who led the surgical team. “Unlike other organs that are all protected inside the body, the lungs are connected to the environment through breathing. It’s one of the most difficult organs to transplant.” 

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