Ruber Internacional Hospital performs the world's first robotic surgery to remove an aggressive tracheal tumor through a single incision and without intubation

Ruber Internacional Hospital has recently performed a world-first surgery: the removal of a highly aggressive tracheal tumor using robotic surgery, through a single entry point and with the patient breathing independently throughout the procedure, without the need for intubation.

The operation was led by Dr. Diego González Rivas and Dr. Régulo José Ávila, internationally renowned thoracic surgeons, and was performed on a Venezuelan patient who traveled to Spain for treatment after being deemed inoperable in his home country.

The tumor was located in the carina, the most complex area of the airway, where the trachea branches into the bronchi. According to Dr. González Rivas, "this is the worst possible location, as any complication directly affects breathing." The uniqueness of the procedure lies in the fact that the Da Vinci robot allowed the surgery to be performed through a single incision of just four centimeters in the chest, avoiding multiple surgical accesses and keeping the patient sedated, but without mechanical ventilation.

A high-risk curative procedure
The procedure consisted of sectioning the trachea and reconstructing the carina, without the need to remove lung tissue, despite the fact that squamous cell carcinoma had invaded the right bronchus and part of the left bronchus. This is an extremely rare surgery: "A thoracic surgeon may see one or two such cases in their entire professional career," emphasizes González Rivas.

Although the procedure was successful and the prognosis is good, Dr. Régulo Ávila acknowledges that it is a high-risk surgery, as any postoperative failure can have serious consequences. However, "without this operation, the patient would have died suddenly within a few months, given that the tumor, measuring about two centimeters, occupied practically the entire diameter of the trachea," González Rivas points out.

Teamwork and international reach
The operation was performed by a multidisciplinary team consisting of four thoracic surgeons, two anesthetists, and three nursing professionals, with the participation of renowned international surgeons.
The Ruber Internacional Hospital played a key role by covering the medical costs and hospitalization, allowing this pioneering procedure to be carried out in Spain thanks to the Diego González Rivas Foundation. In this way, the center has consolidated its position as a leading hospital in advanced and minimally invasive surgery.

A race against time that saved a life
The patient, 66-year-old Pavler Carpio, arrived in Madrid on December 25 after a complicated journey from Venezuela. His case was referred thanks to his daughter, gynecologist Sol Carpio, who contacted Dr. Diego González Rivas through social media. In just eight days, the Foundation planned and performed surgery at the Ruber Internacional Hospital that prevented a fatal outcome.

This procedure represents a new milestone in robotic thoracic surgery, combining for the first time in the world a single entry port, advanced robotic surgery, and anesthesia without intubation, marking a before and after in the treatment of complex airway tumors