(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 TEÔ), 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 NSÔ) 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”.
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