Dr. Christopher Schlachta,
Medical Director of CSTAR (Canadian Surgical Technologies & Advanced Robotics)

building the
future of surgery

As a centre for innovation, LHSC takes great pride in building upon its legacy of medical breakthroughs. In recent years, LHSC surgeons have made significant progress in the field of minimally-invasive robotic-assisted surgery at cstar (canadian surgical Technologies & Advanced Robotics).

"I am a strong believer that the future of surgery is going to be computer-assisted, image-guided and robotic-assisted," says Dr. Christopher Schlachta, Medical Director of CSTAR, an LHSC research and education program in partnershipwith Lawson Health Research Institute and The University of Western Ontario.


On April 3, 2007, Dr. Schlachta, assisted by Dr. Ward Davies, LHSC's Chief of General Surgery, performed a robotic-assisted common bile duct exploration using CSTAR's da Vinci robot. It was a Canadian first. The use of robotics in Canada has tended to be in cardiac surgery and urologic surgery, making this particular innovation all the more significant for taking place in general surgery.

Dr. Schlachta and Dr. Davies had already performed a number of minimally-invasive gallbladder surgeries together using the da Vinci robot. It was when planning surgery for an elderly patient who had a large gallstone lodged in the bile duct that the surgeons decided to consider something new.

The method most commonly used at LHSCto dislodge a gallstone from the bile duct is that of ERCP (Endoscopic Retrograde Cholangio-Pancreatography), which is accomplishedusing a scope through the mouth, rather than surgery. But the patient, in this instance, hadan anatomical abnormality that precludedthis option.

Using the da Vinci robot for this very complex surgery on the bile duct promised all the benefits of minimally-invasive robotic surgery for the patient, 84. For conventional surgery, the patient would have been facing a one-week stay.

"We asked the patient what she would think of being the first to undergo this procedure at LHSC, a procedure done perhaps only five orsix times before in the world," says Dr. Schlachta. The patient agreed.

Life cannot continue without an intact and functioning bile duct. The bile duct carries bile from the liver and the gallbladder into the small intestine, where it helps to digest fat. A blockage of the bile duct can be life-threatening.

What is it like to perform a new surgical technique for the first time? "You go into it having a lot of experience and knowing how to do the operation the conventional way," saysDr. Schlachta, "but there is still a certain amount of trepidation since it is the first time with this new technology. A basic tenet of medicine is to do no harm. We wouldn't attempt it without having confidence in our ability to succeed.In the end, I couldn't believe how easy it wasto do what we wanted to do. It just went incredibly well.

"We derive great pleasure from patient success. To go and see the patient the same day and have her say, I feel good. When can I go home?' We feel a great sense of accomplishment." Discharge from hospital came the next day.

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