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The Globe and Mail

Surgical robot speeds recovery for lung cancer patients

Cutline for CIMG4880 = (from left): Dr. Kazuhiro Yasufuku, Director of the Interventional Thoracic Surgical Program at Toronto General Hospital, University Health Network; Dr. Tom Waddell, thoracic surgeon and Head of the Division of Thoracic Surgery and thoracic surgical fellow Dr. Mauricio Pipkin carefully attach the first of the four robotic arms on to one of the steel ports in the patients chest

Dr. Kazuhiro Yasufuku, Toronto General Hospital, University Health Network

Stanley Skorpid was out of the hospital only days after having a cancerous tumour removed from his lung, back at work and walking his dog, with only four small scars to show for an operation that once involved a large incision.

The Toronto-area resident was the first Canadian beneficiary of a new surgical option that doctors hope will improve the prognosis for those suffering from lung cancer. On Wednesday, four months after the operation, the 78-year-old said he remains free of cancer and has recovered wonderfully.

"I've been shovelling snow maybe three, four times," Mr. Skorpid said. "The doctor told me, everything you did, continue to do. I was afraid to tell him I was shovelling snow and thought I'd catch hell. But no."

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The technique being used at Toronto General Hospital is designed to improve on two previous methods – both of which had their limitations. Robot-assisted technology allows doctors to go into the chest through smaller incisions than the traditional method offered while allowing a level of precision not available to a common minimally-invasive technique.

The technology is manipulated from a nearby console. Using their fingertips, doctors have control of robot arms that dock with the patient's body through stainless-steel ports. One arm is tipped with a scope, offering a high-magnification view on a monitor, while the others wield surgical tools.

"I can actually move the instrument as if you were moving your hands," said Kazuhiro Yasufuku, director of Toronto General's Interventional Thoracic Surgical Program, one of two surgeons there qualified to use the equipment.

The surgery on Mr. Skorpid – who said it was "an honour" to be the first lung cancer sufferer in Canada to be helped by the technology – has been followed by procedures at the hospital on six other people.

Dr. Yasufuku noted that the current standard of care is to remove the lobe of the lung when a tumour between one and three centimetres is found. But he drew an analogy with progress in treating breast cancer, where tumours that once prompted mastectomies now result in lumpectomies, and said that research is being done elsewhere to see if removing less of the surrounding tissue could work for lung cancer as well.

"Now we're seeing smaller and smaller cancers, and I think for these smaller lung cancers the robot allows us to be more precise," said Dr. Yasufuku. "I think in the future we're probably going to ... take less of the lung. And if we do that, the robot is probably better, you can do a more precise dissection."

Dr. Yasufuku and . Tom Waddell, head of thoracic surgery at the hospital, have overseen the seven surgeries using this new technology, which was purchased through a gift from the Muzzo Family Charitable Foundation.

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"One of the issues with lung cancer is patients have very bad prognoses," said Dr. Yasufuku, who hopes the advantages of the method will allow surgery on a wider range of patients, people who will then be able to recover faster.

The new method is meant to improve on video-assisted thoracic surgery (VATS), which is less invasive than a full incision but still involves the surgeon's hands entering the patient's body. Dr. Yasufuku said that it is also "more challenging" with the VATS approach to clear the lymph nodes, a crucial step in lung cancer treatment.

The small incisions are also an improvement over the traditional method, a procedure that involved a large cut and the spreading of the ribs. That technique was not suitable for weaker patients and required longer convalescence.

Because this approach is easier on the patient, recovery time should be reduced, possibly saving the hospital money as people go home more quickly.

Mr. Skorpid, for one, said he was in an a rush to get out of hospital. Within days after surgery he was striding the hospital hallways and in less than a week he was home. The retired CN employee, who has worked 15 years as concierge at a north Toronto apartment building, said he was off the job for a total of three weeks and has since been able to resume his normal life.

"I've been working every day, five days a week," he said. "I feel good."

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