Centre for Minimal Access Surgery (CMAS)

Centre for Minimal Access Surgery

Abbreviation	CMAS
Formation	1999
Founder	Dr Mehran Anvari
Founded at	Hamilton, Ontario, Canada
Affiliations	St Josephs Healthcare Hamilton; McMaster University
Website	http://www.cmas.ca

CMAS is a McMaster University Centre located in St. Joseph's Healthcare Hamilton.

History

CMAS was founded in 1999 by Dr. Mehran Anvari, and is dedicated to teaching and mentoring surgeons. CMAS continues to improve and increase the scope of clinical care available to Canadians, setting standards for laparoscopic surgery in gastro-intestinal, urology and gynecology. CMAS runs approximately 30 educational events per year to train healthcare professionals in the latest techniques of minimal access surgery. The Centre continually incorporates the latest technology into improving and expanding its role in providing modern, safe and effective laparoscopic surgery to patients, and into teaching and mentoring for surgeons in North America and around the world.

CMAS Courses and FLS Centre

CMAS runs a range of courses including Laparoscopic Rectal Surgery, Laparoscopic Hernia Surgery, Laparoscopic Bariatric Surgery, Robotic Surgery, Per-oral Endoscopic Myotome (POEM), Laparoscopic Prostate Surgery, Laparoscopic Renal Surgery, Laparoscopic Gynecology Surgery, and PeriOperative Nursing on-site Training. Programs are focused on improving minimally invasive surgery (MIS) techniques by incorporating select laparoscopic cases in the state-of-the-art surgical suites for interactive dialogue with the operating surgeon, followed by hands on training in both a dry and wet lab. Follow up support is provided for the surgeon once the training is complete.

As of 2013, CMAS is an official Fundamentals of Laparoscopic Surgery (FLS) Testing Centre. Surgical residents, clinical fellows and practicing surgeons from Canada and the USA can complete their FLS Certification at the Hamilton centre. FLS focuses on the skills required to be a laparoscopic surgeon, measuring the surgeon’s knowledge and ability to successfully perform laparoscopic, or MI, surgery. The programs content is a collaboration between SAGES (Society of Gastroesphogeal Surgeons) and ACS (American College of Surgeons).

Telementoring and Telerobotics

Telesurgery Suite at CMAS

The CMAS telehealth, telementoring and telerobotics program was designed to provide training and clinical services to people living in remote areas. Utilizing the expertise and technologies at CMAS, the centre was able to provide real time mentoring to surgeons in North Bay Ontario and Chicoutimi Quebec. To help expand it's telehealth services, CMAS was awarded a grant by the Canadian Health Info-structure Partnership Program (CHIPP), which allowed CMAS to partner with Computer Motion, Bell Canada and Stryker Canada to develop an advanced telerobotic program.

Telesurgery Team in North Bay

On February 28, 2003, Dr. Mehran Anvari, at St. Joseph’s Healthcare, in Hamilton, Ontario successfully performed the world’s first hospital–to–hospital telerobotic–assisted surgery on a patient in North Bay, Ontario, nearly 400 kilometres away. Using a Computer Motion ZEUS TeleSurgical Robot, Drs Anvari and McKinley successfully performed a Nissen Fundoplication. Since then, CMAS and North Bay General Hospital completed 21 telerobotic surgeries (including Hernia Repairs, Gastro Esophageal Reflux Disease (GERD) Surgery, and Colorectal surgery).

NEEMO Projects

NEEMO 7

In October 2004 the joint CMAS, Canadian Space Agency (CSA), NASA and U.S. Army Telemedicine and Advanced Technology Research Center (TATRC) NEEMO 7 mission evaluated telementoring and telerobotic surgery technologies as a way to deliver medical care to astronauts during spaceflight.

NEEMO 7 CMAS science objectives

• Use of a portable ultrasound to locate and measure abdominal organs and structures in a crew member subject,
• Use of a portable ultrasound to insert a small needle and drain into a fluid-filled cystic cavity in a simulated patient,
• Surgical repair of two arteries in a simulated patient,
• Cystoscopy and use of a ureteral basket to remove a renal stone in a simulated patient and,
• Laparoscopic cholecystectomy in a simulated patient.

NEEMO 9

The NEEMO 9 mission (NASA’s Extreme Environment Mission Operations 9) was a joint project involving the Centre for Minimal Access Surgery (CMAS), the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC), the National Space Biomedical Research Institute (NSBRI), and NASA.

It was designed to build on the success of the NEEMO 7 mission and continued to evaluate new medical diagnostic and therapeutic technologies to enhance the delivery of state–of–the–art medical care in remote and harsh environments.

NEEMO 9 CMAS Science objectives

• Telementoring — an experienced surgeon located in an advanced treatment facility is used to pre–established two–way telecommunication links to guide the remote surgeon through an operation in the remote Aquarius habitat. A number of factors were evaluated, including communication latency and semiautonomous functions.
• Telerobotics — surgeons in Hamilton performed real–time abdominal surgery on a patient simulator on the Aquarius undersea habitat. The effect of varying the latency of signal transmission between less than a second to up to 3 seconds, were evaluated to determine the capability to perform telerobotic surgery in a wide range of remote settings on earth and beyond.
• Human Performance, including the effects of fatigue and a number of stressors on the capabilities of the crew to perform complex experiments both inside and outside the undersea habitat were evaluated. This information is of interest to health care professionals on earth and in preparation for exploration missions to the Moon or Mars.

Centre for Minimal Access Surgery (CMAS)

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