A surgical robot just performed one of the world's most common heart operations through tiny cuts between the ribs
At a California hospital, a da Vinci robot helped a surgeon bypass blocked heart arteries without cracking open the chest. The patient was walking the next day.
Key points
- Coronary artery bypass surgery, the world's most common cardiac operation, is performed robotically in fewer than 1% of cases globally.
- Dr. Nels Carroll at El Camino Health Heart and Vascular Institute in California performed the first robotic bypass procedure at the hospital using Intuitive Surgical's da Vinci system.
- Patient Raul Martin, 64, was walking hospital corridors the day after his robotic bypass and went home within a couple of days.
- Robots let surgeons work through small cuts between the ribs instead of sawing through the breastbone, reducing recovery time and pain sharply.
- Surgeon training gaps, referral blindspots, and plain habit explain why robotic bypass remains rare despite the benefits.
Every year, hundreds of thousands of people need a coronary artery bypass, a procedure to reroute blood around a blocked heart artery. It saves lives. Surgeons also have to saw through the breastbone, pull the chest apart, and stitch it back together with steel wire. Recovery takes weeks and hurts a lot.
Now a team in California is doing the same operation through cuts no bigger than a finger-width.
What actually happened?
Surgeons at El Camino Health Heart and Vascular Institute in Mountain View, California, began performing robotic-assisted coronary artery bypass grafting, known as CABG (pronounced "cabbage"), using Intuitive Surgical's da Vinci system, a robotic platform whose thin arms hold tiny instruments and a camera. The first case was led by Dr. Nels Carroll, one of the few surgeons in the San Francisco Bay Area trained in this technique, as first reported by The Robot Report. We covered J&J's rival Ottava surgical robot on 25 July 2026, when the FDA cleared it for ten abdominal procedures; cardiac bypass remains a frontier neither system has conquered at scale.
Carroll uses a plain analogy. The heart is an engine; the arteries on its surface are fuel lines. When those lines fur up with disease, bypass surgery replaces them. "We're just putting on new fuel lines," he told The Robot Report.
Getting to the engine has always been the hard part. "The most challenging thing for the patient is that, historically, we have to cut their chest open," Carroll said. With the da Vinci system, instruments and a camera slide in through small cuts between the ribs. No bone is divided, and no major muscle groups are cut.
What did this mean for a real patient?
Raul Martin, 64, walked three to five miles a day and did resistance training regularly. One Sunday at the gym his smartwatch hit 200 beats per minute. He flagged down a security guard, who called paramedics. Martin ended up at El Camino Health, where Carroll performed the robotic bypass.
The next morning he was moving through the corridors. A couple of days later he went home and returned to his normal routine. That speed is the point: small cuts between the ribs heal in a fundamentally different way from a sawn sternum held together by stainless steel wire.
Why aren't more hospitals doing this?
Fewer than 1% of bypass operations worldwide use a robot, and the reasons are practical.
| Factor | Detail |
|---|---|
| Patient selection | Some cases still need full chest access; robots don't suit every anatomy |
| Surgeon training | Very few cardiac surgeons have learned the technique |
| Referral gaps | Cardiologists and GPs often don't know robotic bypass exists |
| Habit | Surgeons proven in conventional methods are cautious about switching |
Carroll compares adopting a new surgical approach mid-career to changing tactics mid-battle. Once something works reliably, human nature pulls you back to it. The flip side, he notes, is getting stuck.
Robots also help the surgical team. Carroll says a clear shared camera view means everyone in the theatre sees exactly what is happening, which accelerates training for junior surgeons. Physically, a long robotic day leaves his back and neck in far better shape than a conventional one.
The candid judgement here is that the barrier isn't the technology: da Vinci has been in operating rooms for years. What's missing is a generation of cardiac surgeons who trained on it from the start, and a referral culture that knows to ask.
Common questions
Is this available everywhere?
No. Robotic cardiac bypass is offered at only a handful of centres in the United States, and the number of surgeons trained in the technique remains very small. Ask your cardiologist whether a centre near you offers it.
Does the robot operate by itself?
No. The da Vinci system is a tool controlled in real time by the surgeon, who sits at a console and moves the instruments precisely. No AI is making decisions; the surgeon is.
Should patients push their doctor to consider this?
If you or someone you know needs bypass surgery, asking whether a minimally invasive or robotic approach is suitable is reasonable. Not every patient is a candidate, but the question is always worth raising.
