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Dr. Robot, report to the surgery room!
How would you feel if a robot acted as a doctor? Would you be scared or curious? It is a thought that we must ponder about as the discovery of the Fourth Revolution technology has launched humanity into an era where fiction futuristic wonders are about to become real.
Robotics is one such greatest invention, helping the community in its development. While some pop culture fans often compare robotics to the famous movie "Terminator" (even though there is no guarantee it may never happen), the leaders of this industry have found a use for this invention by making it a surgeon.
Making a mark in the history books, the world’s first fully robotic heart transplant was performed on a 16-year-old suffering from end-stage heart failure in Saudi Arabia, King Faisal Specialist Hospital and Research Centre led by Dr. Feras Khaliel.
To explore how robotics could revolutionize patient care and medical practice in the coming years, The Byteline spoke with Dr. Khaliel, who shared insights on the potential of these cutting-edge innovations.
Could you provide more details about the first fully robotic heart transplant procedure?
Healthcare is evolving rapidly, and it is a tremendous honor for King Faisal Specialist Hospital & Research Centre (KFSHRC) to have accomplished the world's first fully robotic heart transplant. This groundbreaking procedure was performed on a 16-year-old patient with end-stage heart failure. The patient’s condition called for a method that would not involve an open chest operation.
In preparation for the surgery, our team undertook extensive practice, conducting seven simulations over three days—to ensure flawless execution. Utilizing the da Vinci Surgical System, we had access to high-definition 3D visualization and enhanced robotic assistance.
This technology allowed for precise dissection and reconstruction deep within the thoracic cavity — all in 2.5 hours, only much lower than the 6 to 12 hours that heart transplants usually require. This pioneering achievement represents a monumental advancement in cardiac surgery, redefining how we approach heart transplants while prioritizing patient comfort and optimal outcomes. We believe this step will be game-changing for cardiac surgery worldwide.
What were some of the unique challenges compared to a traditional heart transplant?
Heart and circulatory diseases continue to be the leading cause of death worldwide. Innovation in surgical techniques is critically important to improve the lives of patients and their families. One of the standout features of the robotic heart transplant procedure is its minimally invasive approach. This is the main differentiator from traditional heart transplants, which typically require large incisions and longer recovery times.
However, employing a robotic surgical system presents its own unique challenges. The system features highly dexterous robotic arms and miniaturized instruments, allowing for intricate maneuvers within a confined surgical space. Mastering the control of these instruments requires a steep learning curve, as the precision needed for effective dissection and suturing is heightened compared to traditional methods. Additionally, robotic surgery does require plenty of preparation time and team training.
How does integrating robotics into heart surgery differ from conventional heart transplants regarding precision, patient safety, and recovery times?
Robotic surgery is known for reducing post-operative pain and helping patients regain their normal routines much faster. Over the past decades, we’ve seen a significant shift from traditional open-heart procedures to minimally invasive cardiac surgery (MICS), driven by rapid technological advancements.
Robotic technology offers a transformative alternative, mainly resulting from the minimally invasive approach and the relatively short duration of the operation. It also presents distinct advantages, such as shorter intensive care and hospital stays, reduced need for blood transfusions, and significantly less pain for patients.
The reduced invasiveness also means there is less systemic inflammation, and the risks of renal and neurological complications are lower. A shorter surgery duration also means shorter cross-clamp times. This refers to the duration during which the aorta is clamped off to prevent blood from entering the heart. Shorter cross-clamp times reduce the risk of complications associated with restricted blood flow to the heart and other organs.
However, one of the most notable advancements we leveraged was the integration of AI-driven analytics. This technology provided real-time visual feedback about the consistency and condition of the tissues we were operating on. Such insights helped us reduce the risk of injury, which is a common concern in traditional surgeries. This shift is about improving outcomes, transforming patient experience, making surgeries smoother overall, and expediting recovery.
Could you share some technical insights on the robotic system used? Who were the manufacturers, and what key features made this technology suitable for such a complex procedure?
The da Vinci Surgical System is a groundbreaking surgical platform that empowers surgeons to perform highly complex procedures with exceptional precision and control. Since its FDA approval over two decades ago, it has transformed minimally invasive surgery, allowing more accurate interventions.
A key differentiator of this system is its high-definition, 3D vision, which provides surgeons with a magnified view of the surgical field, revealing intricate details that would otherwise be imperceptible.
This level of precision is paramount in procedures like heart surgery, where accuracy is critical to successful outcomes. Furthermore, the system's Force Feedback technology allows surgeons to sense subtle forces during surgery, enhancing their ability to control instruments and minimize trauma to the patient.
Remarkably, KFSHRC has harnessed this technology's transformative potential to redefine the boundaries of surgical innovation. Completing the world's first fully robotic heart transplant with this system is a testament to our commitment to advancing medical practices and improving the lives of patients on a global scale.
This achievement underscores our dedication to employing cutting-edge technologies, including robotics and AI, to improve treatment outcomes, enhance patient experiences, and optimize operational efficiency.
What is the future of robotics in cardiac surgery and beyond? Which procedures will likely become fully automated or assisted by robotic systems in the coming decade?
The future of robotics in surgery is beyond game-changing. As someone who’s had the privilege of participating in the world’s first fully robotic heart transplant, I’ve seen firsthand what these technologies can achieve. Robotics in surgery has already transformed what was once impossible into reality, and we’re only at the beginning of this journey.
KFSHRC’s Robotic Cardiac Surgery Program has seen incredible success, performing the most robotic cardiac surgeries outside the United States and ranking among the top five globally.
With over 400 surgeries completed and a 98% survival rate, our program has proven the power of robotics in handling complex procedures like multi-valve operations and aortic valve replacements.
Beyond cardiac surgery, we made history by becoming the first hospital in the world to complete a fully robotic liver transplant. So far, we’ve performed 1,195 robotic-assisted procedures across different medical specialties, showcasing our commitment to advancing surgical care.
In the next few years, we will likely see a significant shift towards greater automation, especially in repetitive, precision-driven tasks. Robots can enhance precision and reduce variability in outcomes — something that human fatigue or other limitations can affect — ensuring consistent accuracy every time.
I like to think of it as giving surgeons superpowers. We’re moving from using our hands as the ultimate surgical tools to having robots as an extension of our skill and precision. The key lies in the thoughtful integration of AI—we can foresee complications, personalize surgical strategies, and adapt in real-time, making surgery smarter and safer.
Introducing new technology always comes with risks. How do you balance leveraging cutting-edge tools and ensuring patient safety during complex procedures?
Robotic surgery, much like traditional surgery, carries an amount of risk, although with low complication rates. At KFSHRC, our approach begins with a world-class robotic surgery program fully compliant with safety best practices and a commitment to rigorous risk management strategies.
One of the first steps is a comprehensive evaluation through clinical risk management. This involves testing, simulation, and multi-disciplinary team input to identify potential risks before any new procedure is performed on a patient. For example, before undertaking our robotic heart transplant, our team engaged in extensive virtual simulations to refine every step of the process.
AI tools are increasingly necessary for enhancing patient safety. AI systems are adept at risk prediction, foreseeing patient complications based on vast amounts of real-time data from electronic health records (EHRs). Surgeons are now more empowered to make better-informed decisions before and during surgery, reducing potential errors and complications even in complex operations.
Yet, the key to successfully implementing these technologies is maintaining human oversight and adaptability. This means regularly validating AI models to detect biases, ensuring data quality, and incorporating clinician feedback to refine AI systems.
Introducing new technology is as much about preparing our teams as it is about the technology itself. We emphasize a multidisciplinary approach. Teams of surgeons, engineers, and data specialists closely monitor and adjust technology integration.
Balancing innovation with safety is about compliance with best practices, transparency, rigorous testing, and team management. Ultimately, our goal is to provide patients with the best care possible — merging the precision of advanced technology with the expertise of our teams.
What advice would you give aspiring surgeons looking to specialize in robotic surgery? What kind of training or certification should they focus on?
My advice to aspiring surgeons is to master the fundamentals of traditional surgery first; robotics is an advanced tool built on these core skills.
Pursue specialized training, like the Da Vinci Surgical System Certification, and consider fellowships in Minimally Invasive and Robotic Surgery through global organizations like the American Association for Thoracic Surgery (AATS) to gain hands-on expertise.
Stay updated on emerging technologies, especially AI and machine learning, through advanced courses from world-class organizations.
Most importantly, always put the patient first; technology enhances outcomes, but your skill, empathy, and adaptability make a difference. Never stop learning and challenging yourself; innovation is critical to transforming patient care.
Aside from robotics, what other Fourth Industrial Revolution technologies, such as AI or blockchain, do you foresee being integrated into hospital systems shortly? How will these impact patient care and hospital operations?
Technology is already embedded throughout our organization. KFSHRC is integrating AI, blockchain, and IoT to revolutionize healthcare. Our AI-driven Capacity Command Center has facilitated over 300,000 interventions, reducing emergency wait times and optimizing bed management. AI has improved diagnostic accuracy by 25% and reduced misdiagnosis by 18%.
Likewise, blockchain ensures secure medical record management, boosting data integrity and patient trust, while IoT supports real-time health monitoring, allowing for proactive care. KFSHRC launched its Blockchain Lab in 2021, rolling out a digital credentialing solution in line with Saudi Vision 2030’s digitalization goals.
Technologies like ANFAL, which uses AI for predictive analytics, are transforming decision-making and care delivery. Being recognized among the ‘World’s Best Smart Hospitals for 2025’ by Newsweek highlights our commitment to innovation that improves lives, ultimately making healthcare more innovative, more efficient, and patient-centric.