The Christ Hospital Performs World’s First Totally Endoscopic Robotic Replacement of the Ascending Aorta

CINCINNATI (August 13, 2026) - Juan B. Umana-Pizano, MD, a cardiothoracic surgeon specializing in robotic and minimally invasive cardiac surgery with The Christ Hospital Heart & Vascular Institute, led the world's first totally endoscopic robotic replacement of the ascending aorta to treat an aortic aneurysm.

Replacing the portion of the ascending aorta weakened by an aneurysm is an established heart surgery. What is new is performing the operation using a totally endoscopic robotic approach. Traditionally, the procedure requires a sternotomy, in which the breastbone is divided to provide access to the heart and aorta.

During the procedure, Dr. Umana, Dr. J. Michael Smith and The Christ Hospital cardiac surgery team used the da Vinci 5 surgical system to remove the weakened section of the patient's ascending aorta and replace it with a surgical graft. The robotic system provided a magnified view of the surgical field and allowed the team to complete the procedure through small incisions between the ribs rather than a traditional sternotomy or thoracotomy.

"Ascending aortic replacement is not a new operation. What is new is our ability to perform it using a totally endoscopic robotic approach," said Dr. Umana. "This is one of the most complex areas of the heart to reach through a minimally invasive approach. Completing this procedure without dividing the patient's breastbone shows how far robotic cardiac surgery has advanced at The Christ Hospital and gives us a foundation to treat more complex aortic disease in the future."

An ascending aortic aneurysm develops when the wall of the aorta-the body's largest artery-weakens and enlarges in the section closest to the heart. If the aneurysm continues to grow, the aorta can tear or rupture and cause life-threatening internal bleeding. Surgery replaces the weakened section with a durable graft before those complications occur.

For appropriately selected patients, a robotic approach may offer benefits associated with minimally invasive heart surgery, including smaller incisions, less surgical trauma, the potential for less pain and a faster recovery. Eligibility depends on the location and complexity of the aneurysm, whether other heart procedures are needed and the patient's overall health.

Michael Smith, MD, president of The Christ Hospital Heart & Vascular Institute and a pioneer in robotic cardiac surgery, supported Dr. Umana to develop the approach and preparation of the cardiac surgery team for the procedure.

"Dr. Umana is an exceptional cardiothoracic surgeon who came to The Christ Hospital Health Network with the experience and drive to move robotic heart surgery forward," said Dr. Smith. "He identified a procedure that has traditionally required a sternotomy and worked through every detail needed to perform it using a totally endoscopic robotic approach. Our role was to give him and the team the support required to make it happen."

The procedure required extensive planning and coordination among cardiac surgeons, cardiac anesthesiologists, perfusionists, nurses, imaging specialists and operating room team members.

"This was not about using a robot simply because we could," said Dr. Umana. "It was about finding a less invasive way to perform a necessary heart operation while maintaining the same surgical goals as the traditional open procedure."

The milestone builds on The Christ Hospital Heart & Vascular Institute's experience in robotic cardiac surgery and its work to make minimally invasive approaches available for increasingly complex heart conditions.

About The Christ Hospital Health Network
The Christ Hospital Health Network consists of an acute care hospital located in Mt. Auburn, a remote hospital location in Liberty Township, five ambulatory outpatient centers and dozens of medical offices throughout the region. For 137 years, The Christ Hospital has provided compassionate care to those it serves. Made up of more than 1,300 physicians and more than 7,600 team members, our mission is to improve the health of our community by providing exceptional outcomes in an affordable way. The Network was recognized by U.S. News & World Report as the #3 hospital in Ohio and named to Newsweek's World's Best Hospitals list in 2026.

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