(LONDON, Ontario) – A Southwestern Ontario man
has become the first in the world to undergo a
robotic procedure that aims to reduce the chance
of clot formation and stroke for high risk patients
suffering from Atrial Fibrillation (AF). The
procedure called a robotic assisted left atrial
appendage ligation was performed at London
Health Sciences Centre (LHSC) by an
interdisciplinary team of surgeon/scientists from
CSTAR (Canadian Surgical Technologies &
Advanced Robotics) and Lawson Health Research
Institute (Lawson) and will provide patients with AF
another treatment option.
Atrial fibrillation is a major burden to the
aging population. This common cardiac condition
is a disturbance of the heart’s normal rhythm and
is estimated to affect over 100,000 people in
Canada. With this medical condition, the upper
chambers of the heart contract in a rapid,
uncoordinated way causing an irregular heartbeat.
This rapid, irregular heartbeat causes symptoms
such as dizziness and shortness of breath. It can
lead to an increase in clot formations and stroke
and in many cases is a sign of advanced heart
disease.
Treatment options usually include blood-
thinning medication or surgery. Although left atrial
appendage ligations are performed routinely
using a minimally invasive approach at LHSC and
at other centres, often the chest is opened to
access the heart resulting in prolonged
hospitalization. This was the first time that the
procedure was performed with the use of the da
Vinci® surgical robot as a solitary procedure in
order to keep the surgery as least invasive as
possible.
Ruthven Ontario resident Joe Policella had
never heard of AF before he suffered a mild stroke
while vacationing in Florida. The 72-year-old
recent retiree was not a candidate for blood
thinning medication and the prospect of
undergoing invasive surgery carried significant
risks given his age. Dr. Bob Kiaii, cardiac surgeon
at LHSC and CSTAR scientist, suggested a robotic
option to Policella. “The decision to do this
surgery robotically was a family decision and we
were confident in Dr. Kiaii’s abilities”, explains
Policella’s daughter Nina.
“Being able to perform this procedure fully
robotic-assisted allows us greater precision and
less chance of complications that could potentially
make a less invasive procedure an invasive one”,
says Dr. Kiaii. “The four-armed da Vinci® robot
makes a huge difference and provides a
significant advantage by providing
greater dexterity and accuracy that I would not
have – even with the minimally invasive
thorascopic approaches.”
After the robotic surgery, Maria Policella was
surprised at how good her husband looked. “His
recovery was very good. When I saw him after the
surgery I couldn’t believe he just had surgery.” Joe
Policella returned home within 3 days of the
surgery and within a couple of weeks returned to
his active life and regular routine. “I wanted to get
back to the gym,” joked “Papa Joe” during a follow-
up examination with Dr. Kiaii.
“CSTAR continues to expand the frontiers of
robotic surgery,“ says Tony Dagnone, President
and CEO of London Health Sciences Centre. “The
accelerated pace of medical advancement by the
CSTAR team provides enormous contributions to
the future of medicine and ultimately to high
quality of patient care.”
“Robotics is revolutionizing the way surgery is
done,” explains Dr. John Denstedt, Citywide Chief
of Surgery at LHSC and St. Joseph’s Healthcare
London. “This procedure is another major step
forward in the process of ensuring successful
patient outcomes”.
Dr. Kiaii stresses that while this procedure is
not a cure for atrial fibrillation, it does offer
another treatment option for high-risk patients
suffering from AF.
This procedure is one of many “firsts” at
CSTAR. Most recently in October 2004, an
interdisciplinary medical team led by Dr. Bob
Kiaii, leader of CSTAR’s Robotic Coronary Artery
Bypass research project and cardiac surgeon at
LHSC, and Dr. Bill Kostuk, cardiologist at LHSC,
were the first in North America to complete two
different procedures to clear blocked arteries
during the same episode of care. Both a
minimally invasive robotic-assisted heart bypass
surgery and angioplasty with stenting were
performed sequentially in time in the same
operating room. Advanced technology such as 3-D
imaging in CSTAR’s specialized Hybrid Operating
Room/Angiosuite at London Health Sciences
Centre, one of a few such facilities in the world,
has made this new intervention possible.
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 $18.8 million from the
Canada Foundation for Innovation, the Ontario
Government and industry 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:
Bärbel Hatje
Communication Consultant
London Health Sciences Centre
519-685-8500, ext. 35947
E-mail: barbel.hatje@lhsc.on.ca
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. 77696
E-mail: jayne.graham@c-star.ca