Video Assisted Thoracic Surgery provides high quality and safe surgical care at Toronto’s St. Joseph’s Health Centre

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With the arrival of Dr. Maurice Blitz to St. Joseph’s Health Centre’s Thoracic Surgery service, the hospital now has the skills and expertise to provide Video Assisted Thoracic Surgery (VATS), a form of minimally invasive surgery (MIS) to treat patients suffering from lung and esophageal cancer, as well as other diseases of the chest.

St. Joseph’s Health Centre provides a complete range of thoracic surgical procedures through our Surgery and Oncology program. “The majority of the work we do here at St. Joseph’s is cancer related, but we also treat benign diseases of the lung, diaphragm, esophagus and stomach, reflux disease, as well as hyperhydrosis,” explains Dr. Blitz. “Most hospitals across the country do minimally invasive surgical approaches to benign esophageal diseases and for routine procedures. The biggest change for St. Joseph’s is that we can now provide more advanced MIS approaches for benign diseases in the esophagus, as well as perform VATS for entire esophagectomies, which is still uncommon in the province,” he said.

In regards to lung cancer surgery, VATS is new here at St. Joseph’s as well as in the province. “With my arrival to St. Joseph’s, I also helped to train and educate our other thoracic surgeons on how to perform lobectomies through minimally invasive surgery,” said Dr. Blitz. Prior to his joining St. Joseph’s, only minor procedures such as wedge resections and biopsies were being conducted through VATS, but now we can provide this innovative approach for both minor surgery and major life-saving cancer surgeries, he said.

The proper surgery to treat lung cancer patients is to remove the lobe, tumour and associated lymph nodes, explained Dr. Blitz. “The traditional way to do this surgery requires a large incision and spreading the ribs with a large chest retractor. This causes a lot of pain and post-operative difficulties for the patient, both short-term and long-term,” said Dr. Blitz. “Now we can do many of these surgeries without the large incision or rib-spreading, through smaller incisions, using cameras. It is very important that we can still provide the same (lung) cancer surgeries as we did before but in a way that is less painful for patients, that reduces their stay in hospital, and gets them back to everyday life.”

MIS procedures such as VATS also benefits patients because it helps reduce their risk of suffering an adverse event such as developing deep vein thrombosis or pulmonary embolisms, because they experience less pain after surgery and can recover more quickly, explains Dr. Lloyd Smith, Chief of Surgery at St. Joseph’s.

“The Department of Surgery at St. Joseph’s Health Centre has been focused on converting traditional surgeries to more minimally invasive approaches in the last 10 years. The addition of Dr. Blitz has allowed us to now focus on this type of surgery when it comes to thoracic surgical procedures,” said Dr. Smith.

St. Joseph’s conducts approximately 200 lobectomies for lung cancer each year. “We are certainly a high volume centre for this, and we will be able to conduct more surgeries and treat more patients now that VATS is routinely being done here,” Dr. Smith said.

Providing lung cancer surgery via VATS is significant to St. Joseph’s for a number of reasons. “First and foremost is that it is important to our patients. I think they get the best, most up-to-date treatment that they can for what is a very difficult disease,” said Dr. Blitz. “As a local community teaching hospital, we are able to get patients seen and processed through their treatment, including leading up to (surgery) and post-operative treatment (i.e. chemotherapy) if needed, more quickly and more efficiently. From a teaching perspective, it’s great for the residents and fellows that we have training here so they can get exposure to these techniques and learn them as well.”

In addition to providing VATS procedures and mentoring our thoracic surgeons, Dr. Blitz has been a great champion of implementing the surgical safety check list in our operating rooms, being one of the first surgeons here to start this practice. “He has acted as a physician leader to champion and help disseminate the practice throughout the entire operating room,” said Dr. Smith. “This further demonstrates our commitment to providing high quality and safe surgical care for our patients.”