Research Projects in Robotic Surgery
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St. Joseph’s Healthcare Hamilton is an academic research community focused on improving the quality of life for our patients and community members, as well as those diagnosed with a diverse range of medical conditions around the world.
Our community is a place where:
- every patient is engaged
- every clinician, allied health professional and employee is an explorer
- the disciplines of science advance in willing partnership
- improving quality of life is the primary metric
We function as a scientific community for the good of our community and the world we share. Our community includes world-class researchers working alongside local clinicians and students – fostering a culture of exploration, innovation and inquiry.
Research Projects in the Boris Family Centre for Robotic Surgery
Thoracic Surgery Research
- St. Joseph’s Healthcare Hamilton is leading a systemic review of literature on robotics assisted surgery in thoracics, as currently there is very little academic research completed in the field of robotic thoracic surgery.
- Working closing with the University Health Network and Toronto General Hospital, we will launch the first ever randomized clinical trial to compare robotic surgery to traditional minimally invasive surgery in the treatment of lung cancer.
- Leading a multidisciplinary collaboration between Thoracic Surgery, Pathology and Interventional Radiology to create new surgical technology using Near Infra-Red Imaging in Robotic Surgery for Lung Cancer
- Leading a national effort to understand the learning curves and cost implications of robotic surgery program on publicly funded healthcare
- Robotic Lung Cancer Resection in Obese Patients is Safer than Thoracoscopic Resection: Thoracic surgeons at St. Joseph’s Healthcare Hamilton are examining whether robot-assisted lung resections in obese patients could be associated with a lower risk of conversion to thoracotomy when compared to video-assisted thoracoscopic lung resections. This is an inter-continen tal study looking at a collective patient population of more than 30,000 of who received the robotic-assisted procedure.
- Will patients pay a supplement for Robotic Thoracic Surgery? A Survey of Canadian Patients
A health outcome and economic study is currently underway at St. Joe’s that involves the perceptions of patients who have had robot-assisted surgeries for their thoracic cancer. The study is entitled “Willingness to Pay: A Survey of Canadian Patients’ Willingness to Contribute to the Cost of Robotic Thoracic Surgery”. This study involves patients from the Division of Thoracic Surgery and its aim is to assess the willingness of Canadian patients to contribute to the cost of robotic surgery in order to have access to the robotic technology, as opposed to traditional methods which involve laparoscopy and open procedures. The intent of the study is to demonstrate to public policy makers the health outcomes following robotic surgery are such that patients would be open to contributing to their care if they had access to technology that would improve their care and their recovery. It is important to note: St. Joe's has not, does not, and will not offer robotic-assisted procedures to patients on the basis of willingness or ability to pay or contribute. Access to care is based solely on clinical evidence and suitability for the procedure. Showing improved patient outcomes and cost-effectiveness of robotic-assisted procedures may encourage the province to consider making robotic surgery the standard of care for some conditions.
Head & Neck Surgery Research
- St. Joseph’s Healthcare Hamilton is working with Western University on a randomized clinical trial aimed at helping to determine best practices for the treatment of oropharyngeal cancer. The study is aiming to recruit 120 patients, 60 of whom will receive transoral robotic surgery, and 60 of whom will receive radiation treatment. The data from the study will be used to examine quality of life, side effects and survival rates.
Urology Surgery Research
- Rocco Stitch Study
The Rocco Stitch is a surgical technique that may have the potential to yield improved patient outcomes for patients undergoing a robotic assisted prostatectomy, including urinary continence and erectile function. Currently 78 patients are enrolled in the study and the Urology Research team is hoping to recruit a total of 150 patients for a randomized controlled trial. - Robotic Assisted Laparoscopic Radical Prostatectomy Delphi/Validation Study
This research study is aimed at developing a tool to assess the competency of surgical trainees. The Delphi portion of the study which collected expert consensus on the steps required to perform a Robotic-Assisted Laparoscopic Prostatectomy is largely complete and is currently being transcribed by the research team. The next step is the Validation portion of the study which looks at rating how well each of the steps of the surgery are performed via video evidence. This study won first prize at the Canadian Urological Association annual meeting in 2014 during Urology Resident Research Day. - Robotic Surgical Skill Acquisition
Currently there is no curriculum in medical schools to teach residents the techniques required to perform robotic-assisted surgery. Recognizing this as an opportunity to further our teaching and research mandate, St. Joseph’s Healthcare Hamilton has partnered with McMaster University to examine how skills learned in a robotic surgery simulation laboratory are transferred into use in the operating room. This study will be used to guide the introduction of robotic surgery simulation into the training of future surgeons in McMaster University’s department of surgery. - Economic Evaluation of Robot-assisted Radical Prostatectomy Compared to Open Radical Prostatectomy (Urology)
This study compares the cost effectiveness of robot-assisted versus open radical prostatectomy in the context of Ontario’s public payer health system. The study found that robotic-assisted procedures are in fact cost-effective in Ontario, challenging the conclusions from an earlier assessment conducted by the province. Contributing to the results include evidence that robot-assisted radical prostatectomies have a lower incidence of adverse events, such as urinary incontinence and erectile dysfunction, compared to procedures that are “open”, not robot-assisted. The results of the study were published last year in the Canadian Urologic Association Journal
Orthopaedic Robotic Surgery Research
- Outcomes and Impact of Orthopaedic Robotic Surgery for Partial and Total Joint Replacements
Total knee arthroplasty (TKA) (commonly known as knee replacement surgery), is the second most common surgical procedure performed in Canada. Total knee replacements can often restore much of a patient’s lost knee function, but no artificial replacement can replicate the range of motion of a natural knee. Since TKA procedures affect the entire knee, all three compartments – medial, lateral, and patellofemoral – are replaced whether or not they are all compromised. Researchers at St. Joe’s are exploring novel alternatives to TKA. This includes unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BiKA) – both of which are partial knee replacement procedures affecting only one or two compartments, instead of the entire knee. These partial replacements are much more technically challenging compared to a total replacement, necessitating the use of the MAKO RIO Orthopaedic surgical robot. To determine whether robotic surgery for joint replacement procedures is superior to conventional techniques, a team of St. Joe’s orthopaedic researchers are conducting a major study that will consider a number of factors, including function, gait analysis, recovery time, patient satisfaction, surgical time, complications, implant survival, and cost-effectiveness. Read more here.