Baird News

The people who make ground breaking clinical trials happen have been honoured. These are the people who save and improve lives across Australia and around the world by funding, designing, conducting or participating in clinical trials.

As a continuous and dedicated supporter of all cardiothoracic and vascular surgery clinical trials conducted with patients undergoing heart and lung surgery at RPAH, it is our great pleasure at The Baird Institute to report that the ATACAS trial is the winner of the 2017 ACTA Clinical Trial of the Year Award at the recent Clinical Trials 2017 National Tribute and Awards Ceremony.  The ceremony recognised the significant advancements and improvements made to the health of all Australians through clinical trials.

Professor Paul Bannon, Chairman of The Baird Institute, talks to the ABC News about the opening of the country’s first robotic surgery training facility called the “RPA Surgical and Robotic Training Institute” at Royal Prince Alfred Hospital.

The facility will have the ability to train up to 400 surgeons each year in the use of the robot and as a result, more patients will have access to these less invasive procedures on the operating table.  The robot used to train the surgeons at the Institute cost around $4 million.

Robotic surgery allows us to perform complex procedures at a distance, with great precision and great control”, says Professor Bannon.  With this technology, surgeons make less invasive incisions which result in better outcomes and improved recovery times for the patient.  A quicker recovery means less time in hospital which in turn means a lower cost.

The robots have been used for several years in Australia, largely in private hospitals. However, Australian surgeons have had to travel overseas to develop their skills and this has been difficult due to the costs involved and a surgeon’s busy schedule.

Now, with the opening of the new training institute, the surgeons will be able to advance their knowledge in Australia, without the necessity to travel overseas.  This in turn will allow more public patients access to the less invasive procedures that robot allows.

Robotic surgery allows us to perform complex procedures at a distance, with great precision and great control.

We want to know how to teach robotic surgery and how to teach it better and we want to know exactly what the benefits to the patients are.

A robotics surgery symposium will be held in late June where doctors will discuss having a national register for surgeons who provide robotic treatment. The meeting will also address discretionary surgeon fees for such procedures.

View the original ABC News story here

KEY POINTS

• For more than a decade, robotic machines have largely been used in private hospitals for procedures like robotic prostatectomy to treat prostate cancer and robotic mitral valve surgery for heart failure patients.
• Nepean Hospital has been using robots for four years in the public system, however surgeons still had to travel to the United States for some of their training.
• A 2016 Australian study published in prestigious journal The Lancet questioned the value of using expensive robotic technology to treat prostate cancer patients.
• The Surgical and Robotics Training Institute will also collect patient outcome data and present its findings to state and federal governments.

Two of The Baird Institute’s Cardiac Surgeons, Prof Paul Bannon and Prof Michael Wilson, issue a warning over government policy on the ABC’s 7.30 Report.

The warning relates to government policy on a revolutionary keyhole heart surgery procedure called TAVI (Transcatheter Aortic Valve Implant) where the aortic valve is replaced without the need for open-heart surgery.  A surgeon inserts a new aortic valve into an artery with a very small wire, usually through the groin. The wire is then carefully manoeuvred up to the heart and inside the existing valve.

The government’s policy mandates that for this type of valve implant surgery, there is only the need for just one principal operator at the table, despite repeated warnings by both the Cardiology Society and the Surgical Society that this could result in dire consequences for the patients undergoing this procedure, even death!  The surgeons and cardiologists’ recommendation is for there be two operators – a cardiac surgeon and a cardiologist – working side by side and they would like the government to make this mandatory.

In the Unites States of America, the government has listened to the advice of the professional societies as well as the surgeons and cardiologists performing the procedure, that both a cardiologist and a surgeon – the “Heart Team” – be involved in operations involving the technique of Transcatheter Aortic Valve Implants.  In order to ensure that this happens, the government has made this a condition of payment.  Professor Michael Mack from the Bayler Heart Hospital in Texas who is a pioneer of the TAVI technique, said that he really believes that the government in the United States have got it right this time.

The surgeons explain that cost is not the issue as they are prepared to split the fee with the cardiologists so this will not cost the government any more than a single operator model.  Professor Bannon says that once the government rolls this out in November of 2017, they “would be morally and ethically bound not to allow the patients through to a single operator model”,

Experience has told us that we need to have cardiac surgeons and cardiologists at every step of the way;  at the decision making step, all the way through to the care of the patient and at the operating table.  You need both skill sets there from beginning to end.

If something goes bad with the heart and the heart stops beating, you’ve got about five minutes until you have irreparable brain damage … so you don’t have a lot of time to muck around and find a solution and get somebody into the room [to assist, therefore] we both need to be here and work collaboratively.

KEY POINTS

• Government advisory committee recommends single principal operator for procedure
• Surgeons say two principal operators are needed — a surgeon and a cardiologist
• Surgeons warn they may boycott the procedure if two principal operators are not used

View the original story featured on the ABC here

The Baird Institute’s Annual “Cocktails & Conversation” was held on December 7, 2016 at the Wooloomooloo Bay Hotel, Sydney.

For more details from the evening, including photos, please view the follow-up news item here: A Year of Achievements Celebrated at the Annual Baird Institute Christmas Party.