Canadian first in bypass surgery for CSTAR


The latest clinical research at CSTAR (Canadian Surgical Technologies & Advanced Robotics) in London, Ontario shows promise to revolutionize cardiac bypass surgery.

Last November, a highly skilled surgical team, which included cardiovascular surgeon Alan Menkis and cardiac surgeon Bob Kiaii, was the first in Canada to use the four-armed da Vinci robot and Medtronic’s Starfish NS Heart Positioner in cardiac surgery. They were also the first in North America to use Medtronic’s Octopus TE Heart Stabilizer. The surgery was performed at London Health Sciences Centre.

In a minimally invasive approach on a beating heart, the four arms of the robot, which include an endoscopic camera, are inserted into small two-inch incisions in the patient’s chest. The surgeon then manipulates the robotic arms to retrieve the internal mammary artery (IMA) in the chest wall, which is needed to bypass the blocked artery.

The heart positioner and heart stabilizer are then inserted through the small incisions to complete the bypass. These tools use suction-cup like devices to gently move, hold and stabilize the heart for anastomosis, which is bypassing the blocked artery and suturing or sewing the new artery to restore blood flow to the heart.

According to Dr. Menkis, “The innovative heart stabilizer and positioner provide much better stabilization of the heart, and allow us to move and hold the heart in different positions, which provides greater access to more arteries. As result, we believe this will enable us to soon perform multiple bypass surgery in a minimally-invasive approach instead of conventional open-heart surgery, and that is great news for patients.”

Minimally invasive surgery, including robotic surgery, benefits the patient in many ways, including reduced trauma to the body, less post-operative pain, a shorter hospital stay and a faster recovery.

“The four-armed da Vinci robot provides a surgeon with the greatest dexterity to date in surgical robotics, along with better visualization through three dimensional imaging, and that will allow us to chart many new horizons in minimally invasive surgery,” says Dr. Kiaii.

CSTAR is Canada’s national centre for developing and testing the next generation of minimally invasive surgical technologies and techniques, including robotics. CSTAR is a collaborative research program of London Health Sciences Centre and Lawson Health Research Institute, and is affiliated with The University of Western Ontario. Funding is provided in part by the Canada Foundation for Innovation and the London Health Sciences Foundation.

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