One year, one hundred lives later.

Let’s make one thing clear – robots don’t perform surgery. Rather, the skills of trained surgeons are enhanced by a robotic operating system called da Vinci. This system makes no decisions on its own and acts as an extension of a surgeon’s own hands, but with superior visualization, manipulation and precision. 

The da Vinci system seamlessly replicates the movement of the surgeon using the remote-controlled micro-instruments, performing surgery through small incisions in a patient’s chest or abdomen. This partnership of human and machine can reduce trauma to the patient’s body, duration of hospital stays, blood loss, transfusions, and the use of pain medication. 

“You certainly feel like you’re doing a better surgery because you can see the different planes much more easily,” says Dr. Jason Izard, a surgeon at Kingston Health Sciences Centre (KHSC). “The instruments you have to work with are so small that the movements and dissection is much more precise.”

Laparoscopic surgeries, which also use minimally invasive approaches, are not new to KHSC. But, surgeons are limited by inflexible tools and must work in a prolonged awkward position to get the best visibility of the surgical site. With the assistance of the robotic control console, physicians can improve both their visual and physical access to the surgical site and perform incredibly delicate movements with ease. 

“We have been expanding our capabilities – both the scale and scope – in minimally invasive surgical procedures for many years,” says KHSC CEO Dr. David Pichora. “The evolution is not new, but there has been a rapid expansion and escalation of what we can do with the addition of the robotic-assisted technology.” 

Michael Laframboise and his wife, Teena, have been married for 55 years. They have four children, eleven grandchildren, and two great-grandchildren. In 2017, a biopsy showed Michael was in the early stages of prostate cancer. After two years of close monitoring, and a second biopsy revealing that the cancer had spread, Michael started researching his options. 

“There wasn’t a day that went by that I didn’t think to myself ‘I have cancer’,” says Michael. “We talked about alternatives. I looked at radiation; I wasn’t a candidate for brachytherapy. I wanted it taken out.”

After learning he was a candidate for robotic-assisted surgery, Michael immediately went to work researching the ins and outs of the procedure – a prostatectomy. 

“I knew it was what I wanted. I was as excited as you can be when you are facing a life-threatening cancer,” says Michael. “I had no fears about the surgery. I knew I was in good hands.” 

Two days after the surgery, Michael was walking down to the docks near his home on Treasure Island. By October, his route was back up to its typical length of two and a half miles. “I guess I’ve progressed,” Michael says with a chuckle. “I’m feeling much like my old self.” 

Arguably, the most difficult part of the entire surgical experience for Michael and his family was waiting for the results of a post-operative pathology report. In early October, the Laframboise clan got the news they were hoping for – Michael is now cancer-free. 

Janice Kelly, an operating room nurse at KHSC, has been working robotic surgical cases since the da Vinci system was first brought to Kingston. 

“The learning experience has been absolutely incredible,” says Janice. “It’s innovative from a nursing perspective too, and it’s amazing to see the outcome for the patients.” 

With a myriad of advantages, it’s no surprise that robotic-assisted surgery is on its way to becoming the new standard of care in North America. It has become a keystone technology used in providing minimally invasive surgeries and is the ideal approach for a growing number of clinical situations. 

“This program is bringing the hospital up to speed with what is happening in the medical profession,” explains Janice.  “It’s an opportunity for KHSC to make a name for itself because we are providing this outstanding care for our population.” 

Right now, the robotic-assisted option is offered for certain types of prostate, rectal, gynecological and general surgeries, but plans are being made to expand the program for even more patients who could benefit from this innovative surgical approach. 

“If we don’t jump on board with robotics now, we will be left behind in the next decade,” says Dr. Romy Nitch, medical lead for surgery and chair of the robotic implementation committee at KHSC. “We came in at an opportune time. If we are able to build a strong, sustainable program there is huge potential to grow here.” 

Though technically retired, Kathleen likes to stay busy by working and conducting research for a local professional and author. She has lived throughout Canada, and even spent a number of years living in the Caribbean. 

“Everyone always asks me why I came back,” she laughs. “I missed my family. It was time to come home.” 

Kathleen is no stranger to surgery - the 64 year old has had 12 operations in her lifetime. Last summer, Kathleen learned that her uterus needed to be removed, which is when she first learned about robotic-assisted surgery. 

“I wasn’t against it, I just didn’t know anything about it,” explains Kathleen. All I knew is that I wanted this surgery done as quickly as possible.” 

It didn’t take long to convince Kathleen that a robotic-assisted surgery was the way to go. Aside from being able to have her surgery quickly, the biggest benefit she saw was being able to manage her post-op pain without medication. 

“I have a very low tolerance to medications,” explains Kathleen. “With this type of surgery, the pain normally would be so much higher. I was rating my pain afterwards at a level three [out of ten]. I’ve had many other surgeries and let me tell you, there was a huge difference. The pain was so much more manageable.” 

After four weeks of recovery, Kathleen, along with her niece and great-nephew, packed up the minivan and travelled all over Ontario– something the family wouldn’t have been able to do if Kathleen had a traditional hysterectomy. 

“It was an unbelievably better experience,” she says. “There is less chance of infection. There was less downtime than I would have ever thought. I’ve never felt more confident about a prognosis or procedure than I did with this one.”

We have the skilled clinicians, the patients, and the technology, but we are missing one key piece to secure the future of the program: ongoing donor support. Robotic technology is expensive, and community donations are needed to secure the program and allow it to thrive.  

KHSC is fortunate to benefit from the support of local philanthropist Britton Smith, whose generous donation allowed the hospital to purchase the da Vinci robotic operating system. To recognize his support, the program has been named the A. Britton Smith Q.C Robotics Program.  

“It required significant group effort and community support to bring da Vinci to our centre and we will require ongoing philanthropy to sustain the program,” explains Dr. Nitch. “I feel quite proud that we’ve been able to bring this technology on board. We have challenges ahead from a funding point of view, but I’m optimistic we will get there.”