This article was written by Jennifer Bieman and originally appears in the London Free Press, August 1, 2019. Click here to view the full article.
Already a hub for robotic operations, Southwestern Ontario’s largest hospital is celebrating a first-in-Ontario robotic brain surgery that’s helped a 14-year-old boy become seizure-free.
With the help of a specialized robot, pediatric brain surgeons at the Children’s Hospital at London Health Sciences Centre implanted tiny electrodes deep into the teen’s brain, a surgery typically performed on adults.
“It is a game-changer and it has allowed us to bring in patients that, in the old days we thought were not candidates for surgery, and evaluate them and potentially give them the opportunity to be free of seizures,” said Andrea Andrade, pediatric neurologist and medical director of the pediatric epilepsy program at Children’s Hospital.
Ethan, the young patient who declined to use his surname to protect his privacy, is fully recovered from his robot-assisted stereoelectroencephalography (SEEG) procedure in October.
Using the Renishaw robot at University Hospital, surgeons implanted electrodes into different parts of the Ethan’s brain Oct. 4, 2018. The electrodes remained in place for a couple of weeks and made it possible for doctors to precisely pinpoint where his seizures were happening, Andrade said.
With the seizure-causing brain activity mapped, doctors took out the electrodes and addressed problem seizure sites in the brain in a subsequent surgery Oct. 22. Ethan has been seizure-free since.
“It was pretty tough before surgery. I was in the hospital a lot,” he said. “Now, I can do lots of things that I couldn’t do before. I can go to overnight camps now, I can play football, I can hang out with friends.”
“He’s a totally different child now,” Andrade said.
Ethan’s seizures began when he was nine years old and were difficult to control with medication and other non-surgical treatment, Andrade said. At his worst, he was experiencing 15- to 20-second seizures several times an hour for three straight days.
After exhausting other options, doctors determined the teen was a good candidate for the minimally invasive robot-assisted brain surgery.
Ethan’s surgery is the latest provincial first in LHSC’s epilepsy program. In 2017, the hospital became the first in Ontario to perform the robot-assisted electrode placement surgery.
Going under the knife to treat epilepsy is seen as a “last resort” by the public, especially for young patients, Andrade said, but it shouldn’t be.
“We really want to change that mentality,” she said. “Epilepsy surgery, especially in pediatric patients, is something that can completely change the trajectory of a brain that is in a very critical time of development.
“If we remove that seizure burden, that seizure focus from a child’s brain, we’re going to give them the best tools for that brain to develop properly.”
Epilepsy is a brain disorder characterized by unpredictable, recurrent seizures. About one in 100 Canadians have epilepsy, with most new cases diagnosed in young children and seniors.
Other robotic surgery firsts at LHSC
2017 – LHSC becomes the first in Ontario to perform a robot-assisted electrode-placement surgery in the brain of a patient with epilepsy
2016 – The colorectal team performs Canada’s first robotic surgery to fix the placement of a rectum and treat obstructive defecation syndrome
2013 – An LHSC surgeon becomes the first in Canada to perform a robotic single-site gallbladder removal.
2011 – Surgeons at LHSC become the first in the world to use a da Vinci robot to fix a hole in the heart caused by a pacemaker complication
2008 – Surgeons use a da Vinci robot to complete a world-first intestinal bypass surgery on a patient with superior mesenteric artery syndrome
2005 – Man with atrial fibrillation undergoes a world-first robotic surgery to reduce risk of stroke-causing clots
2001 – Pulmonary surgery team performs a world-first robotic-assisted lung volume reduction procedure, removing damaged tissue to help patient breathe better
1999 – World first closed-chest, robot assisted, coronary artery bypass graft on a beating heart
