More than 100 surgeries done but where is the money to keep robot surgeon operating?

Warning: video contains graphic images

By Julia Chapman, CBC News

Posted: Apr 26, 2013 7:43 AM ET

Last Updated: Apr 26, 2013 8:19 AM ET

The surgeon looks through the viewer to see a 3D image of the patient. (St. Joseph's)

Winston Sardine reads through the notes he wrote after his prostate surgery last May.

"The operating room experience was somewhat brief, just enough time to look at the multi-armed equipment as they were securing me onto the operating table and getting me hooked up to the anesthetic and then, lights out," wrote the 71-year-old from Hagersville.

Sardine's surgical experience at Hamilton's St Joseph's Healthcare was a unique one, which is clear to him looking back at those notes. He laughs before he read about the "multi-armed equipment" that performed his procedure.

He is one of over a hundred patients who underwent surgery in the last year with the da Vinci Surgical robot system, one of the most advanced surgical tools in the world and the only one in the local health network.

But with the initial funding running out there is uncertainty about where the money will come from to keep it operating. Dr. Bobby Shayegan, uro oncologist and chair of the robotic program at St. Joseph's said it is so successful that the hospital will find a way, including asking for private donations.

"For a physician its much more accurate technology. I have a range of movements that a human hand would not have, so what I can do with a small, narrow male pelvis is more than I can ever do with my own hand," said Dr. Shayegan.

Shayegan helped bring the da Vinci to the Hamilton hospital in late 2011 before putting it into use a few months later in 2012. He uses the robot primarily for urological surgeries, like removal of the prostate, but it can also perform gynecological, cardiac, thoracic and oral procedures with a trained surgeon, Shayegan said.

After Sardine was diagnosed with prostate cancer and met with Shayegan about surgery, he researched the da Vinci robot, watching procedures posted online. Noting that the robotic surgery seemed "less intrusive," he chose that option over a traditional procedure.

"I've had absolutely zero problems [post-surgery]," Sardine said. "I understand from a number of people, including my doctor and my wife's doctor, that this is unusual."

Sardine said its typical of patients who have their prostate removed to experience incontinence for up to six weeks after surgery, but it didn't happen to him. Shayegan performed Sardine's prostate surgery on May 7 of last year, and he was back at home on May 9.

"There is not doubt in my mind that it improves outcomes for patients, recovery of urinary control is faster, blood loss is very very small, they're not in hospital very long, " Shayegan said. "It's a vast leap for patients."

But now St. Joe's is dealing with a funding issue. The da Vinci came to Hamilton with a philanthropic donation of $2.3 million, but now it's but up to the hospital to maintain. With the exception of Alberta, no Canadian provincial or territorial government helps with the cost of surgical robots.

Shayegan said it costs about $3500 more per surgery compared to a traditional procedure. He alone has done over a hundred surgeries with the robot since it came to the hospital, totaling to at least $350,000. On top of that is a $180,000 annual maintenance cost.

"So far, we've had 100 per cent patient satisfaction," Shayegan said. "I hope we can translate that into some funding."