Michael Borisko
Dr. Alexander Lee performs keyhole surgery at SRHC
Health
June 23, 2008 03:12 PM
beingwell magazine Summer 2008
By: Kim Goggins
It’s difficult for Tom Breckles to describe exactly what he felt in his throat.
It wasn’t pain and it didn’t feel like a blockage but something was definitely not right.
When test results determined the 90-year-old Scarborough man had cancer of the esophagus, a close family friend told him about Dr. Alexander Lee and the innovative keyhole surgery he performs at Southlake Regional Health Centre.
“I said (to my family doctor) there is some kind of laparoscopic surgery which I understand is not nearly as intrusive as the old kind of surgery,” Mr. Breckles recalls of his experience just over a year ago. “The next thing I know, I was up there for an interview and then a series of tests started and finally I had the operation (last year).”
This minimally invasive surgery (MIS), also called Video-Assisted Thoracoscopic Surgery (VATS) or keyhole surgery, involves a much smaller incision than conventional thoracic surgery and a touch-free approach using scopes, cameras and tiny instruments. As one of only five surgeons in Ontario who use the procedure for thoracic oncology, it accounts for about 80 per cent of the surgeries performed by Dr. Lee.
Mr. Breckles recovered in hospital for only nine days and was able to resume his normal routine after a few weeks at home. It’s this quick recovery time that is one of the significant benefits of VATS, notes Dr. Julius Toth, head of Southlake’s thoracic surgery program.
“The time to recover is shortened with diminished pain for the patient, thus a surgical option can be offered for those who may otherwise be excluded due to their higher risk category,” he explains.
In the last two years, the program has performed more thoracic surgeries for lung and esophageal cancer than the other five acute-care hospitals in the Central Local Health Integration Network (LHIN) combined and is the fourth busiest thoracic program in Ontario.
Dr. Lee was hired in 2006 to bring the MIS procedure to Southlake’s thoracic program. Currently, less than five per cent of esophagectomies performed in North America use the progressive procedure that he performed on Mr. Breckles, a fact that undoubtedly raises the profile of the program as it emerges as a level one centre of excellence in the region.
But, as Dr. Lee points out, many factors are considered when selecting patients for keyhole surgery and it is not performed if conventional surgery is a better solution.
“The guiding principle is you cannot compromise the quality and outcome of your cancer surgery just to do something via minimally invasive surgery,” he said.
Mr. Breckles was one of 211 patients with a cancer diagnosis who underwent thoracic cancer surgery at Southlake in 2007.
The program’s reach extends throughout York Region and far beyond the Central LHIN boundaries north to Collingwood, Midland and Huntsville, to just north of Lindsay, south to Beaverton and west to Orangeville, encompassing about 1.5 million people. Two satellite clinics, one at Headwaters Healthcare Centre in Orangeville and the other at Orillia Soldiers’ Memorial Hospital, make it possible for more patients to access the program closer to home.
“The Southlake satellite clinics allow patients needing long-term cancer care to receive their pre-operative investigation, consultation, post-operative care or follow-up care close to home,” Dr. Lee explains. If patients do run into problems while in convalescence, they will not have to travel far to get the care they need, he adds.
The development of more satellite clinics will allow even more patients in the vast area served by Southlake’s thoracic program to be treated in their home community, reducing the stress that comes with travel and being away from family.
As Southlake prepares for the opening of its Regional Cancer Centre in 2009, Dr. Toth expects to recruit a third thoracic surgeon to the program and further expand its service area via satellite clinics.
“It’s a very exciting time and the hospital administration has been extremely supportive, as has the community,” Dr. Toth notes. “It’s only through their ongoing assistance and support that we’ve been able to do any of this.”
In the last two years, the program has performed more thoracic surgeries for lung and esophageal cancer than the other five acute-care hospitals in the Central Local Health Integration Network (LHIN) combined and is the fourth busiest thoracic program in Ontario.