Multi Vessel Small Thorocotomy (MVST) a First for Canada

Southwestern Ontario man first Canadian to undergo minimally invasive robotically assisted double bypass surgery (LONDON, Ontario) – A year ago, Randy Klatt of Corunna, Ontario could barely walk without having pain and a burning sensation in his chest. Now the 52-year-old engineer is taking scuba diving lessons and working out at the gym, due to the success of a minimally invasive double bypass robotic procedure performed at University Hospital, London Health Sciences Centre (LHSC). For the first time in Canada, the procedure called a Multi Vessel Small Thorocotomy (MVST) was completed with the use of the robotic da Vinci® surgical system by an interdisciplinary team of surgeon/scientists from CSTAR (Canadian Surgical Technologies & Advanced Robotics) and Lawson Health Research Institute (Lawson). Heart bypass surgery is one of the most common major operations in Canada. According to the most recent statistics from the Canadian Institute for Health Information, 33 hospitals in this country performed almost 22,500 bypass surgeries in 1998/99. Conventional coronary artery bypass operations involve the surgeon cutting a long incision into the chest and sawing open the breastbone (sternum) to gain access to the heart. In this way, the surgeon can then fix a clogged artery by sewing a healthy blood vessel into the artery just above the blockage. To perform much delicate stitching, it is usually necessary for surgeons to temporarily stop the heart and put the patient on a heart-lung machine to oxygenate the blood. However, this highly invasive procedure is in sharp contrast to the minimally invasive robotic assisted cardiac surgery on a beating heart conducted at LHSC and this latest Canadian first. According to CSTAR researcher and LHSC cardiac surgeon Dr. Bob Kiaii, Randy Klatt was the ideal candidate for this procedure as his 2 (double) vessel blockages were in the branches of the left side of his heart. The left side allows for easier access to the blockage through a small incision between the ribs with no requirement to cut the breastbone in half. Innovative endoscopic technology from Medtronic of Canada Limited including a stabilizer (Octopus TE), allows the area of the heart that is being operated on to remain stable while the heart is beating. This allows for proper suturing to be performed. An endoscopic positioner (Starfish NS) also enables the surgeon to expose areas of the heart that are usually not accessible through a small incision. “Performing this procedure with the addition of robotic assistance enables the harvesting of the artery to be used for the bypass, to be performed by the surgeon more precisely and with greater ease”, explains Dr. Kiaii. “It also is less invasive for the patient and reduces the risk of complications such as post operative inflammation, less pain and makes for a quicker recovery”. “Four days later I was home with very little scarring and feeling pretty good, “ says Randy Klatt. “I went back to work very quickly and now I can do any kind of activity I want to including scuba diving”. –2- Dr. Kiaii and his team have performed close to 90 robotic cardiac procedures (bypass surgery and angioplasty) using the da Vinci® robot including a robotic assisted left atrial appendage ligation, which aids in the treatment of atrial fibrillation. Dr. Kiaii and Dr. Bill Kostuk were also the first in North America to complete two different procedures to clear 2 blocked arteries during the same episode of care using CSTAR’s specialized Hybrid Operating Room/AngioSuite at LHSC, one of only a few such facilities in the world. “Innovative research into the use of robotics in cardiac surgery at CSTAR is continuing to revolutionize patient care”, says LHSC President and CEO Tony Dagnone, “and this procedure is another significant achievement we can be proud of”. According to CSTAR’s Medical Director Dr. Christopher Schlachta, “In pushing the frontier of minimally invasive robotic surgery, we know that these accomplishments will ultimately improve quality of care and reduce waiting lists”. This research at CSTAR is supported by grants from the Canada Foundation for Innovation and the Ontario Government. ### About CSTAR CSTAR (Canadian Surgical Technologies & Advanced Robotics) is Canada’s national centre for developing and testing the next generation of minimally invasive surgical and interventional technologies and techniques, including robotics. CSTAR trains the surgeons of the future and shares expertise around the world. Building on world and national firsts pioneered by surgeons in London, CSTAR was launched in December 2001. CSTAR is a collaborative research program of London Health Sciences Centre (LHSC) and Lawson Health Research Institute (Lawson), and is affiliated with The University of Western Ontario (Western). CSTAR is one of the first interdisciplinary research and training facility in the world to bring together practitioners, students, and researchers in surgery, engineering, imaging, robotics, information technology and business. Project teams have attracted $20.4 million through peer-reviewed grants and the private sector to fund discoveries in many areas of medicine, from robotic fetal procedures to cancer therapy. Visit CSTAR today at www.c-star.ca For more information, please contact: Jayne Graham Manager, Communications CSTAR (Canadian Surgical Technologies & Advanced Robotics) London Health Sciences Centre 339 Windermere Road London, Ontario, N6A 5A5 Telephone: (519) 685-8500 ext. 32111 E-mail: jayne.graham@c-star.ca