Healing a tiny patient

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As nurses bustled around preparing for her surgery, one-year-old Victoria Lampman lay on the operating table watching Finding Nemo on the flat screen television at the end of the operating room. Her mother held her hand, waiting for the anesthetic to take effect and for Victoria to fall asleep.

Victoria is one of the first patients to undergo surgery in the new pediatric endosuite at McMaster Children’s Hospital (MCH). An endosuite is a state-of-the-art environment for performing minimally invasive surgical procedures. These procedures involve the insertion of a tiny scope into the patient. Using the images from the camera attached to the scope, and specialized tiny instruments, doctors can perform operations without making large incisions. This means less pain and scarring for the patient and a speedier recovery.

McMaster Children’s Hospital is the first children’s health-care facility in Canada to have a pediatric endosuite and Victoria was one of the first children to benefit.

Shortly after her birth, Victoria was diagnosed with a PDA, or Patent Ductus Arteriosus, an opening at the connection of two major blood vessels near the heart. This opening normally closes after birth, but in Victoria’s case it didn’t close completely.

Using the technology of the new endosuite, Dr. Peter Fitzgerald, head of pediatric surgery at McMaster Children’s Hospital, closed the opening between the blood vessels with a small metal clip, thus completely correcting the problem. And the clip was inserted requiring only three tiny incisions under Victoria’s arm.

From a technical standpoint, the pediatric endosuite makes minimally invasive surgery much easier to perform. All of the equipment is placed in such a way that the surgeon and health-care team can perform their jobs in ergonomically correct positions, an important feature especially for lengthy operations. The endosuite also allows the surgeon to operate the machines using voice-activated technology. By speaking into a headset, the light source in the scope and cameras can be controlled by the surgeon and adjusted at the exact moment required.

The endosuite technology means that even the smallest of patients can benefit from minimally invasive surgery. The new endosuite has advanced image quality that is essential for procedures in these small patients.

In Victoria’s case, the size of the area being operated on within her chest was smaller than the diameter of a toonie. A scope, inserted through a tiny incision under her arm, magnified the area and projected it onto one of three plasma screens surrounding the operating table.

Pediatric surgeons at MCH have long been considered leaders in minimally invasive surgery and are currently some of the only pediatric surgeons in the country performing advanced minimally invasive chest surgery. As leaders in the field, they have also trained other surgeons in Canada and internationally, some from as far away as the Middle East.

“The new endosuite will allow our pediatric surgeons to share their expertise with physicians around the world,” said Dr. Fitzgerald. “The equipment in the endosuite can transmit video and audio of the surgery in real time to other centres anywhere in the world, allowing other doctors to watch and learn from the surgeries taking place at MCH.”

In addition to making the surgeon’s job easier and the teaching benefits, the endosuite also has tremendous benefits for patients. If Victoria Lampman had been at almost any other children’s hospital in the country, doctors would have had to make a large incision and perform the operation through her ribcage. Her scarring would have been much more noticeable and her recovery time considerably longer. Fortunately, Victoria was able to go home less than 24 hours after her surgery.

A wide variety of minimally invasive pediatric surgery cases are performed each year at MCH. In addition to chest surgery, the minimally invasive procedures can be used for various bowel surgeries, appendectomies and splenectomies.

The pediatric endosuite cost approximately $1 million and was funded completely through donations from the community. More than $600,000 of those donations came from the annual Mac Kids Invitational, a premier golf experience that requires players to raise a minimum of $5,000 each.

“You could be the best surgeon in the world, but you need to have the right equipment in order to do your job well,” said Dr. Fitzgerald. “Victoria and many other patients like her will benefit from the pediatric endosuite and the generosity of the Hamilton community.”