"Traditionally, we were trained believing that 'the bigger the scar the bigger the surgeon'. This paradigm has fundamentally changed and now reads 'the smaller the scar the bigger the surgeon'. Indeed, surgery was performed by laparotomy using large incisions resulting in large scars. However in recent years surgeons have gradually shifted to the minimally invasive approach resulting in shorter hospital stay, fewer complications, and better quality of life.
Robotic surgery, originally developed by NASA to perform surgeries in space stations, has found its way into the civilian operating room. It is revolutionizing access to minimally invasive surgery and patient outcome thanks to improved three dimensional high definition immersion vision and intuitive surgical dexterity with more degrees of freedom compared to the human hand.
Since its introduction at the Jewish General hospital five years ago, the results indicate major benefits of this surgical approach, with lower peri-operative complications, reduced need for pain medications, shorter hospital stay and lower real average hospital costs, as compared to traditional open surgery. In addition, the team was able to increase the proportion of patients benefiting from a minimally invasive surgical approach for certain cancers from 17%, prior to the introduction of the Da Vinci Robot, to over 95% within 2 years.
As our team began seeing the benefits of robotic surgery to patients from a clinical outcomes perspective and to the health care system from a resource utilization and cost perspective, we were emboldened to make the case for its use to patients in Quebec (the McGill University Health Centre, Université de Montréal, Université de Laval), across Canada (The University of Ottawa, St. Michael’s Hospital in Toronto, University of Alberta and Vancouver General Hospital) and internationally (China, India, Israel).
The future of robotic-assisted surgery will evolve with the further development of the computer interface present between the surgeon and the patient, that will allow to integrate radiological images obtained prior to surgery into the surgical screen , and by exploiting real time digital analysis of the surgical field, helping the surgeon to identify structures based on differences in color or movement. Pre-operative training on computerized simulation of the surgery and added feedback loops are being developed to further increase safety ultimately benefiting the patients."
Dr. Walter H. Gotlieb, M.D., Ph.D.
Director of Surgical Oncology of McGill University
and world authority on surgical robotics technology.
Walter H. Gotlieb completed his medical degree summa cum laude at the Université Libre de Bruxelles, in his native Belgium, where he went on to obtain board certification in Ob-Gyn.
Following two years at the National Institutes of Health, where he obtained the National Cancer Institute Award of Outstanding Performance, he performed a three year fellowship in Gyn-onc at UCLA. He was then recruited by the by Tel Aviv University, Tel Hashomer Hospital, where he co-founded and built up the Department of Gynaecologic-Oncology from 1994 to 2003.
In 2003, he was recruited by McGill University. He obtained license to practice in Europe, Israel, California, and Canada. In addition to his clinical responsibilities, he is involved in scientific research in ovarian cancer as a Project Director in the Lady Davis Research Institute and Senior Scientist of the Montreal Center for Experimental Therapeutics and Cancer. His efforts focus on translational research and novel therapeutic tools for ovarian cancer, and he has been the pioneer and driven “robotic” surgery in gynaecologic cancer in Canada. He has lectured around the world, and has proctored robotic surgery in Canada, China, India, and Israel.
A recipient of twelve national and international awards in the area of cancer research, Dr. Gotlieb is well published with over 100 peer-reviewed manuscripts in reputable international journals. Dr. Gotlieb presently sits on the executive council of the International Gynecologic Cancer Society, and is the secretary treasurer of the Gynecologic Oncology Society of Canada. He is senior editor of the International Journal of Gynecologic Cancer. His prior involvement with medical societies includes the executive council of the Israel Gynecologic Oncologists, the executive council of the Society of Gynecologic Oncologists of Canada, the SGO 2006 program committee, the International Committee of the SGO, and Vice President of the Association des Gynécologues Oncologues du Québec.
Dr. Gotlieb is presently Professor of Ob-Gyn and of Oncology at McGill University. He is the Director of Gynecologic Oncology at the Segal Cancer Center of the Jewish General Hospital, and Director of Surgical Oncology at McGill University. He recently completed an executive course in health care management and delivery at the Harvard Business School.
Photo of Dr. Gotlieb: courtesy of the Jewish General Hospital
Photos of the Da Vinci robotic surgery technology: courtesy of Intuitive Surgical Inc.
Dr. Gotlieb biography courtesy of the Jewish General Hospital
Dr. Gotlieb statement courtesy of Dr. Gotlieb
S.P.A.C.E. is very grateful to Maureen McIntyre of the Fine Arts Department for her initiative and commitment to this project.
Sarah De Guzman: Lighting and Theatre Technician