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Toronto (Feb. 27, 2020) – A team comprised of breast surgeons from UHN's Sprott Department of Surgery and a visiting French surgeon performed Canada's first bilateral nipple-sparing mastectomy and immediate breast reconstruction with the use of the surgical robot. This procedure was developed in Paris and Milan and is available in only a handful of centres around the world.
UHN surgeons are leading the way in Canada through a clinical trial that will investigate the surgical and quality of life outcomes for robotic nipple-sparing mastectomies. This innovative technique will help women who are at high risk for developing breast cancer and those that need breast cancer treatment.
The ground-breaking surgery was the first in Dr. Tulin Cil's clinical trial and a Canadian first. A very experienced surgeon in the open nipple-sparing technique, Dr. Cil performed the minimally invasive robotic operation with visiting surgeon, Dr. Benjamin Sarfati of France, who had instructed her on the technique in France. Dr. Sarfati is a pioneer in this new application of robotics and has performed over a hundred robotic nipple-sparing mastectomies.
The data from research in multiple centres supports the short-term safety of robotic mastectomy as well as the potential for greater benefits over the traditional open approach to the mastectomy, which involves an incision around the nipple or under the breast fold. Since the robotic mastectomy uses a smaller incision in the underarm area, there are lower rates of infection and complications such as lack of blood supply to the skin and nipple. Despite the smaller incision, there is no compromise of the cancer principles in performing the robotic mastectomy – all of the tissue is removed in one segment, just as surgeons do in the open approach, due to the improved visualization and instrumentation provided by the robotic approach.
"One of the challenges in the open nipple-sparing mastectomy is the ability to visualize the extent of the breast tissue, especially the farther you get from the incision," says Dr. Cil. "The robotic approach allows us to have a better view and more precise access to the entire breast tissue that needs to be removed. This has the potential to actually improve the surgery we do." Furthermore, the cosmetic results of the operation are superior. More data will be expected from a large Italian study soon to be completed.
For the team at UHN, this is just the beginning. Dr. Cil and her co-investigators in plastic surgery, Drs. Stefan Hofer and Anne O'Neill, hope to enroll 30 patients in the trial over the next year. The goal is to establish a state-of-the-art program in robotic breast surgery that will incorporate excellence in clinical care, cutting edge research and surgical education.
University Health Network consists of Toronto General, recently voted one of the Top 10 Hospitals in the World according to Newsweek Magazine, and Toronto Western Hospital, the Princess Margaret Cancer Centre, Toronto Rehabilitation Institute, and the Michener Institute of Education at UHN. The scope of research and complexity of cases at University Health Network has made it a national and international source of discovery, education and patient care. It has the largest hospital-based research program in Canada, with major research in cardiology, transplantation, neurosciences, oncology, surgical innovation, infectious diseases, genomic medicine and rehabilitation medicine. University Health Network is a research hospital affiliated with the University of Toronto.
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