Collaroy’s John Swan became the first Australian to undergo a groundbreaking, fully robotic coronary bypass in December, marking a medical milestone for Northern Beaches Hospital
In a monumental leap for Australian medicine, Northern Beaches Hospital has successfully performed the country’s first totally endoscopic coronary artery bypass (TECAB) surgery on Collaroy resident John Swan.
Renowned cardiothoracic surgeon Professor Michael Wilson and his specialist team carried out the procedure on grandfather-of-eight John using the Da Vinci Xi Robotic Surgical System – which resembles a futuristic octopus – and the medic’s own adaptations.
‘We want patients to have the best long-term result and freedom from recurrent heart disease and survival.’ Prof Michael Wilson
John, 81, says the surgery involved only five fingertip-sized cuts instead of a long incision – a stark contrast and less invasive alternative to the conventional method of open-heart surgery, resulting in minimal downtime and a faster recovery.
“I feel so privileged to have had this opportunity,” John says, speaking exclusively to Peninsula Living.
“It was a six-hour operation, and Professor Wilson made five small incisions in my chest. He used three robotic arms and a stabiliser. I told him afterwards, ‘I’d have loved to have been present to watch all this!’”
John, a former captain with Palm Beach Ferries, suffered from high blood pressure and cholesterol passed on from ‘faulty genes.’
Both his parents died from heart attacks and his sisters have high cholesterol, but John was unaware he could have been close to death if it wasn’t for the urgent intervention.
“I had no idea that anything was wrong!” he laughs. “I was getting out of breath just walking up the hill from the beach to our home.
‘There is no pain whatsoever,’ John Swan said after the operation
“I don’t even need to be on blood pressure pills anymore. It brings tears to my eyes. It’s just magic and I realise how fortunate I am.” John Swan
“I mentioned it to my chiropractor who advised me to have a treadmill stress test as I’ve not had one in about 30 years. They stopped the test in the middle of it as they discovered my main left coronary artery was blocked.”
After looking at his arteries via angiogram and x-rays, Narrabeen cardiologist Peter Ilies referred him to Prof Wilson at Northern Beaches Hospital.
“I remember Dr Ilies saying, ‘If I do the stents, they’ll probably block up in six months, whereas if they do surgery, I might get 15 to 20 years out of it.’ I don’t know that I want that long though!” laughs John.
The father-of-two was referred to Northern Beaches Hospital and was on the operating table under the care of Prof Wilson within 10 days, undergoing Australia’s first and highly-lauded endoscopic coronary artery bypass surgery.
Prof Wilson with nurses at the Northern Beaches Hospital
“The care I received from beginning to end from Professor Wilson, his team and all the staff, from the cleaners to the people serving me food, was exemplary,” says John.
“There’s no pain whatsoever, and I don’t even need to be on blood pressure pills anymore. It brings tears to my eyes. It’s just magic and I realise just how fortunate I am.”
Prof Wilson, who at the time of going to press had carried out three TECAB procedures at Northern Beaches Hospital, is piloting the surgeries with NSW Health and Liverpool Hospital, along with Macquarie University Hospital, in the hope of launching it in the public system.
“It is a network and a systematic ethical approach, underpinned by simulation, image processing and remote expert overseas proctoring to successfully start a new procedure,” he tells Peninsula Living.
“Before doing the first totally robotic operation, we have performed multiple steps of the procedure over the years. We’ve been harvesting the mammary artery for a decade, and we have a simulation model practising sewing with the robot.”
The Da Vinci Xi Robotic Surgical System
“Before doing the first totally robotic operation, we have a simulation model practising sewing with the robot.” Prof Wilson
Prof Wilson says stitching the arteries robotically offers more precision, and he uses a combination of techniques during TECAB surgeries, including a Medtronic stabiliser through a GelPort Access System, which allows the team to stabilise the heart and arteries.
The heart expert decided he wanted to become a surgeon after spending time in hospitals when a friend broke his neck in Year 12 and completed his specialisation in general and cardiothoracic surgery at Royal Prince Alfred Hospital.
He then completed a fellowship in transplantation surgery at Stanford University Hospital in the USA and a cardiac surgery fellowship at Toronto General Hospital.
Prof Wilson has been proctored by Gianluca Torregrossa in Philadelphia and the University of Chicago’s Professor Husam Balkhy, who have pioneered these minimally invasive procedures.
He calls the heart doctors the ‘best, most prolific, coronary bypass robotic surgeons in the world.’
He has diverse interests in most aspects of cardiothoracic surgery, from ischaemic heart disease – including heart failure – to aortic and valvular heart disease and TECAB surgery, and experience in transcatheter aortic valves and minimally invasive mitral surgery.
Prof Wilson says Northern Beaches cardiologists and the hospital are hugely supportive and collaborative of the TECAB pilot, and refer patients who are suitable for this procedure.
While open heart surgery remains as a backup if patients are unstable, Prof Wilson and his team prefer to carry out procedures in a minimally invasive keyhole fashion so the trauma of surgery is vastly reduced.
“It will continue to evolve and get better and allow us to do things with more and more accuracy,” he surmises. “Making surgeries safer is a real driver, and I regard the way I’ve been evolving surgically as heading in this direction for the last two decades.
“We want patients to have the best long-term result and freedom from recurrent heart disease and survival.”
TECAB patient John and wife of 54 years, Margaret, are celebrating his new lease of life this month, cruising on the Queen Elizabeth to Singapore.
“All the credit should go to Prof Michael Wilson and Northern Beaches Hospital. I was just the person on the slab!” laughs John.
