Surgeons at The Christ Hospital in Cincinnati say they have completed the world’s first robotic replacement of the ascending aorta, removing an enlarged section of the body’s largest artery and swapping in a synthetic graft through small incisions between the ribs rather than cracking open a patient’s chest. Dr. Juan B. Umana-Pizano and Dr. J. Michael Smith co-led the cardiac surgery team behind the procedure, according to the hospital’s doctors.
The ascending aorta, the segment closest to the heart, becomes a surgical concern when it weakens and enlarges, and traditionally that kind of repair has meant a sternotomy — dividing the breastbone to open the chest. According to Local 12, the Christ Hospital team instead used a totally endoscopic robotic approach to remove the affected section and replace it with a surgical graft. The hospital’s own account, detailed in a press release, specifies that the team used Intuitive Surgical’s da Vinci 5 system to complete the graft placement through small rib incisions, avoiding the chest-opening breastbone division altogether.
A Track Record Building Toward This Moment
Dr. Smith brought considerable robotic experience into the operating room. He has personally performed more than 4,000 robotic heart procedures over the course of his Cincinnati career, and the announcement of this world-first landed just one day after The Christ Hospital named him President of its Heart & Vascular Institute on August 12. That same day, the hospital also named Dr. Daniel Pelchovitz as Medical Director of the institute, formally restructuring its cardiovascular executive leadership.
Smith was already no stranger to firsts on this platform. In March 2025, he led a Christ Hospital team in performing the first robotic aortic valve replacement in the United States using the da Vinci 5 robot, according to a report from LINK nky. Dr. Umana-Pizano, the lead cardiothoracic surgeon on this latest procedure, earned his medical degree from Universidad de Los Andes in Bogota, Colombia, and completed his surgical residency and fellowship at the Cleveland Clinic before joining the Cincinnati hospital.
Regulatory Timing Lines Up With the Milestone
The operation comes only months after the Food and Drug Administration cleared Intuitive Surgical’s da Vinci 5 system for key cardiac procedures in January, a clearance that prompted the company to pursue a measured rollout emphasizing specialized training for complex heart surgeries, per MedTech Dive. Nationwide, da Vinci robotic procedure volume grew 15% in 2025 to exceed 2 million cases, while robotic cardiac surgery across all da Vinci platforms globally reached roughly 17,000 procedures that same year, the outlet reports…