Canadian Surgical Technologies & Advanced Robotics, also known as CSTAR, has claimed another Canadian first.
In early May, a cardiac surgery team led by Dr. Bob Kiaii, cardiac surgeon and director of Minimally Invasive and Robotic Cardiac Surgery, performed a totally endoscopic closed-chest robotic coronary artery bypass surgery on a patient’s beating heart. The procedure was performed at London Health Sciences Centre (LHSC), University Hospital.
“This procedure represents a revolution in bypass surgery,” said Dr. Bob Kiaii.
“It is due to our cardiac surgery team’s dedication to innovation, and their expertise in robotic surgery, that we were able to use the latest surgical techniques and technologies to directly benefit the patient in a tangible way.”
The surgical team employed a daVinci Robot and used four one-centimeter endoscopic incisions to perform the bypass on a beating heart. The surgery was made possible by the use of a specialized endoscopic heart stabilizer, designed by Medtronic Inc. (Minneapolis, MN), that provided access and stabilization to the bypass area, as well as special sutures, also designed by Medtronic Inc., utilized to simplify and create the bypass connection with the robotic instrumentation.
The minimally invasive nature of the procedure means that the patient only requires a one-to-two day stay in hospital and can recover and return to normal activity in about a week.
Vincent Ianni-Lucio, 38 years old, of Sault Ste. Marie is the first person to undergo the procedure in Canada.
“I still can’t believe I had heart surgery less than a week ago,” said Ianni-Lucio. “I am looking forward to getting back to my usual routines in just a few days”.
Before attempting this new procedure, the surgical team had been using the daVinci Robot to perform coronary artery bypass surgery with a working incision of four-to-five centimeters plus three one-centimeter endoscopic incisions. Patients were required to stay in hospital for three days and needed four-to-six weeks to recover. Larger incisions cause patients more discomfort and longer recovery times as there is more trauma to the body.
Conventional coronary bypass surgery is highly invasive: patients’ hearts are stopped and they are connected to a heart-lung machine during the procedure. An 18 to 20-centimeter incision is made and the breastbone is cut in order to expose the heart. Patients who undergo conventional bypass surgery are typically hospitalized for five-to-six days and generally need three months to recover.
“The CSTAR program represents the future of surgery,” says Cliff Nordal, president and chief executive officer, LHSC. “This procedure demonstrates how we are improving patient care by reducing recovery time and length of stay.”
Led by Dr. Bob Kiaii, the cardiac surgical team consisted of clinical associates in Cardiac Surgery, Dr. Reiza Rayman and Dr. Stuart Swinamer; assistant professor, Department of Anesthesia Dr. Christopher Harle; and cardiac operating room nurses Angela Boyle, Linda Jagelewski, Deborah Carwana and Cathy Mulcahy. Providing key support to the team were Research Robotics Specialists David Browning and David Harrison.
This is the second Canadian first for CSTAR and London Health Sciences Centre in recent weeks. On April 3rd, 2007, surgeons had performed the first Canadian robotic assisted common bile duct exploration using the daVinci robot.
For more information about CSTAR, visit http://www.c-star.ca.