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July 06, 2000

Nancy Lawrence
Media Relations, LHSC
519-685-8500, ext. 77642

London Health Sciences Centre achieves Canadian first in robotic-assisted cardiac valve surgery

(LONDON, Ontario) - A medical team at London Health Sciences Centre (LHSC) has successfully completed seven minimally-invasive, robotic assisted valve and congenital heart surgeries, including both repairs and replacements. LHSC is one of only seven health centres worldwide performing this type of surgery and the only centre in Canada doing this surgery. The LHSC surgical team is led by Alan Menkis who is also a professor of surgery and paediatrics at The University of Western Ontario.

Minimally-invasive valve surgery has evolved since the mid-1990s. LHSC's acquisition of the AESOP robotically-controlled camera system in 1999 (the same system which allowed LHSC to perform the world's first closed chest, robotic-assisted cardiac bypass surgery on a beating heart in September 1999) has resulted in advances now being made in cardiac mitral valve surgery.

"The use of the robotic technology alongside the minimally-invasive technique means patients are spared the large incisions required with a traditional surgical approach and surgeons enjoy greater precision and stability of the visualiazation system with the AESOP robotic technology. The view you get as a surgeon is incredible," says Dr. Menkis. "This approach also results in minimal blood loss for patients and decreased time on a ventilator after surgery."

Typically, surgeons wait until valves deteriorate significantly before offering traditional valve surgery because the disease usually progresses slowly. The mortality rate for traditional valve surgery is five to six per cent. The expectation with the robotic-assisted surgery is a 99 per cent success rate, says Dr. Menkis. It is also worth noting that patients are not as ill at the time of surgery with the robotic-assisted procedure.

"We believe this new approach will provide patients with a better quality of life earlier in the progression of their disease and allow them the resume active, productive lives. This new approach also means patients can avoid longterm use of medications such as blood thinners which have risks associated with them as well," says Dr. Menkis.

The LHSC team began exploring and developing this technique 18 months ago.

"This progression from large incisions and direct access to small incisions and video-directed surgery is a very exciting area of development in cardiac surgery, and will continue to capture the imagination of surgeons worldwide as these procedures evolve and become an established standard component of heart surgical practice," says Dr. Menkis.

Approximately 15 to 20 per cent of patients requiring valve surgery are potential candidates for this new procedure, says Dr. Menkis, who performs about 100 such surgeries annually. From 1996 to December 31, 1999, more than 600 video-assisted mitral valve repairs and replacements were reported from six centres in Europe and the United States.

LHSC President and CEO, Tony Dagnone, commends the medical team responsible for this accomplishment.

"LHSC is a leader in developing new and innovative surgical techniques which are made possible due to the highly talented staff we have here, including Dr. Menkis and the supporting team. Cardiac care is a premier program at LHSC and one of the largest programs of its kind in Canada. I am proud of this team's achievements and look forward to continued successes," says Dagnone.