Robotic lung transplantation and the evolution of surgical options

There was a time when a lung transplant seemed like science fiction – an impossible idea that lungs, delicate and vital, could be replaced. But over the decades, what once felt unimaginable has become routine for some of the sickest patients. Now, thanks to innovation and collaboration, we’re entering a new era: one where lung transplantation is not only lifesaving but also less invasive, less painful and faster recovery.

That future is unfolding right now at Baylor Medicine, where a team of surgeons recently made history by performing the first robotic-assisted double lung transplant in Texas.

But to understand why this is such a breakthrough, it helps to look back at how far we’ve come.

History of lung transplantation

The first human lung transplant was tried in 1963. The patient survived for just 18 days. It wasn’t until the 1980s that breakthroughs in anti-rejection medications, surgical techniques and postoperative care began turning the tide. Over the years, lung transplantation evolved from experimental to lifesaving, offering hope for patients with diseases like pulmonary fibrosis, cystic fibrosis and chronic obstructive pulmonary disease (COPD).

Even as success rates improved, one thing remained constant: it’s a tough surgery. Traditional lung transplants typically involve large incisions, spread ribs and long, painful recoveries. For many patients – especially those already struggling to breathe – the physical toll of surgery itself is a major challenge.

That’s what makes Baylor’s recent case so remarkable.

A new chapter begins: Robot-assisted surgery

Dr. Ramiro Fernandez and Dr. Gabriel Loor, leaders in thoracic and transplant surgery at Baylor Medicine, performed the first robot-assisted double lung transplant in Texas – and one of the first in the nation in March at Baylor St. Luke’s Medical Center. Surgeons used a state-of-the-art robotic system to remove and replace a patient’s failing lungs through small incisions between the ribs, avoiding the need to split the chest.

The patient, who had advanced COPD, was discharged just five days after surgery – the fastest lung transplant recovery in Baylor St. Luke’s history.

“This is a significant achievement,” said Loor, surgical director of the Lung Transplant Program at Baylor St. Luke’s and associate professor at Baylor College of Medicine. “Robotic-assisted lung transplantation offers the potential to transform how we care for patients with end-stage lung disease.”

The use of robotics in surgery isn’t entirely new – it’s been successfully used for years in urology, gynecology and general surgery. However, using robotic technology for lung transplants is still in its infancy – the first case in the U.S. took place just last fall.

Advantages of robotic surgery

Robotic surgery allows surgeons to operate through tiny openings with unmatched precision and control. The system translates the surgeon’s hand movements into micro-movements of robotic instruments, guided by a high-definition 3D camera. This level of accuracy is particularly valuable in lung transplants, where space is limited and the stakes are high.

Dr. Kenneth Liao, director of the Center for Robotic Cardiothoracic Surgery at Baylor St. Luke’s, has built a specialized team capable of tackling the most complex heart and lung procedures using this technology. Fernandez brings deep experience in both robotic thoracic surgery and transplantation, making this team uniquely positioned to push the boundaries of what’s possible.

“We didn’t just perform a new kind of surgery,” said Fernandez, assistant professor in the David J. Sugarbaker Division of Thoracic Surgery. “We showed that this can be done safely and successfully and that the patient can thrive afterward.”

Changing the outlook for patients

For patients with COPD – a disease that affects more than 250 million people worldwide – this innovation is a ray of hope. COPD slowly robs people of breath, energy and independence. For those with severe disease, when medications and oxygen no longer work, a lung transplant may be the only option. And now, thanks to advancements like robotic surgery, that option is becoming more accessible, more tolerable and more effective.

At Baylor St. Luke’s, the Lung Transplant Program already is one of the most active in the country, with a record 108 lung transplants performed last year alone. With robotic-assisted surgery now added to its toolkit, the team is poised to help even more patients, especially those who might not tolerate traditional open surgery.

The future is here

This historic surgery isn’t just about one patient’s remarkable recovery. It’s about reimagining what’s possible for lung transplant patients everywhere.
From the early days of trial and error to today’s high-tech solutions, lung transplantation has come a long way. And at Baylor, that journey is far from over. With robotic technology and a team committed to innovation, the future of lung transplantation is here – and it’s more hopeful than ever.

By Tiffany Harston, senior communications associate in the Michael E. DeBakey Department of Surgery