In February 2007, just three months after he was married, Kevin Shah and his family were shocked to find out his blurred vision was a result of a tumour at the base of his brain.
Kevin underwent two surgeries in his home country of India, but neither operation successfully removed a significant portion of the tumour.
“We were a little surprised when the surgeries did not go well,” says Shah. “But the tumour was very, very deep and doctors could not access it.”
It was in 2012 that Shah came to The Ottawa Hospital (TOH) to be treated by one of the most cutting-edge teams in the world.
TOH has undergone an incredible transformation over the last few years and is now celebrating a huge achievement: a world-class minimally invasive surgery (MIS) program, which uses innovative technology and techniques that cause as little trauma to patients like Shah as possible.
Based on a strategic plan that took shape under the leadership of Dr. Éric Poulin in 2006, TOH made minimally invasive surgery a major priority and set about recruiting new physicians, building new facilities, and bringing in some of the best technology in the world. As a result, TOH’s MIS program is allowing more rapid and less painful recoveries for thousands of patients across Eastern Ontario, Canada and the world.
“We wanted to make a surgical encounter as uncomplicated as a trip to the dentist,” says Dr. Poulin, Head of the Department of Surgery. “Can you imagine having an operation that lays you up for six weeks or three months, versus an operation where you can go back to work next week?”
Over the years surgical technology has progressed by leaps and bounds, says Dr. Poulin. Long before MIS, a gallbladder operation would result in a hospital stay of nine days. Now, more than 90 per cent of these patients are treated as outpatients with no hospital stay at all.
Over the past year, the hospital has performed groundbreaking minimally invasive procedures across all departments: from bariatric and urology, to gynecology, neurology and beyond.
Shah was referred to TOH surgeons Dr. Amin Kassam, Head of the Division of Neurosurgery, and Dr. Martin Corsten, Head of the Department of Otolaryngology - Head and Neck Surgery, and clinical investigator at the Ottawa Hospital Research Institute (OHRI). Using the revolutionary NICO Myriad, a tiny but incredibly precise multi-functional device that acts as scissors, a dissector and suction device in one, the team was able to operate through Shah’s nose and sinuses to remove 90 per cent of his tumour with little impact to the surrounding brain tissue.
Incredibly, Shah was discharged from the hospital after just three days.
“I feel great,” he says. “When you look at me you’d never know I had such a long, arduous surgery.”
“I didn’t expect that much of the tumour would be removed,” says Jayprakash Shah, Kevin Shah’s father. “For me, it’s a miracle.”
Dr. Kassam and Dr. Corsten have been working together for a number of years, and have dedicated much of this time to refining these minimally invasive techniques and conducting research in the field.
“It’s not just about avoiding incisions, because folks can live with incisions,” says Dr. Corsten. “Minimally invasive surgery brings a dramatically different hospital stay and set of side effects after. This is a tremendous advancement.”
“Ottawa seems to be becoming a destination site for minimally invasive neurosurgery,” says Dr. Kassam, adding that a group of nurses, surgeons, and anesthesiologists collaborate to make these surgeries possible. “I think this success is reflective of a team that truly works together.”
Shah’s story is just one example of the incredible, life-saving work being done every day through TOH’s MIS program.
In 2011, with the help of generous donations from the community, TOH acquired the da Vinci Surgical System – a robotic device that can be used for everything from urologic, gynecologic, and cardiothoracic, to general surgeries.
“Some people think that the da Vinci robot is a robot doing the surgery, which it’s not,” says Dr. Rodney Breau, surgical oncologist at TOH and associate scientist at OHRI, who trained for two years in the United States learning how to use the equipment. “It’s an instrument that allows us to do advanced and complex procedures more easily and with more refined movements.”
With the da Vinci, the surgeon performs every aspect of the surgery through sophisticated controls and a high-definition 3D image – all connected to miniature instruments that operate through tiny cuts the size of a keyhole.
“Having the robot at TOH will mean that patients living in Ottawa and the surrounding area can be treated here with the best technology available,” says Dr. Breau. “With robotic-assisted surgery, our patients are experiencing better outcomes following a surgery and a quicker return to daily life – which is what every patient wants.”
MIS techniques are also improving the patient experience for gastric bypass patients.
“Before minimally invasive techniques, gastric bypass surgery meant a pretty large wound – creating a lot of pain postoperatively,” says Dr. Isabelle Raîche, bariatric surgeon. “Now we can get access to the abdomen with a camera that is only 10 millimetres in size – so instead of a 20-centimetre incision, we have a few incisions the size of my little finger.”
“This decreases infection and hernias, and gets patients back on their feet much faster,” says Dr. Raîche.
Today, minimally invasive techniques and technology are seen throughout all surgical specialties at TOH, not only impacting the patient experience, but also the health-care system in general – reducing wait times and hospital stays.
“This didn’t happen by chance,” says Dr. Breau. “This was the result of a vision, and I think it is really paying off.”
“There is not a single department that is not covered by minimally invasive surgery,” says Dr. Poulin. “The impact on patients, and the health-care system, is unbelievable.”