St. Joseph’s Healthcare Hamilton is the home to a wide variety of innovative healthcare research and treatments, from respiratory care to diabetes research, and even the groundbreaking field of robotic surgery. Over the years, St. Joe’s has been the site of many first of their kind robotic surgeries that were long considered impossible to perform. Behind this transformative care are a number of surgeons, including Dr. Waël Hanna, a thoracic surgeon at St. Joe’s and the division head of Thoracic Surgery at McMaster University.
Our hospital’s journey in robotic surgery began in 2011 when the Marta & Owen Boris Foundation made a $5 million gift that brought the Da Vinci Si – the world’s most advanced surgical robot at the time – to St. Joe’s. Two years later, the Boris Foundation made another $5 million donation that made St. Joseph’s Healthcare Hamilton the home of the first comprehensive robotic surgery centre in Canada, and expanded these surgeries to include procedures of the head, neck, chest, and kidneys. In recognition of this large contribution, St. Joe’s named the new centre the Boris Family Centre for Robotic Surgery. Many other donors have supported the program and provided invaluable funding for several robotic technologies, procedures, and research.
The Role of Robotics in Surgery
When we think about robotics, it’s likely that we picture a robot that functions automatically on an assembly line to construct something like a car or a phone. However, this is very different to what goes on during robotic surgeries.
“Surgical robots don’t work autonomously like we often assume,” Dr. Hanna explains. “In these procedures, the surgeons control the robot as a kind of surgical tool, as if it’s an extension of their own hands. As such, there’s still a team of surgeons and nurses with the patient in the operating room to perform the operation and provide care.”
Pictured: Dr. Waël Hanna
One of the biggest advantages of using robotics in surgery is the increased precision the technology offers. Even surgeons with the steadiest of hands can still experience microscopic tremors. These tremors may not be visible to the naked eye, but they can still cause slight inaccuracies in the tissue that the surgeon removes. When it comes to removing cancerous cells from major organs, any inaccuracies, no matter how small, can have large effects on patient outcomes. Surgical robots offer a level of precision that simply isn’t possible for humans. It can help remove more of a patient’s cancerous tissue while preserving as much healthy tissue as possible.
Robotic tools can also enter much smaller spaces than human hands can, so the incisions that surgeons make don’t have to be as large when compared to the same operations without the use of robotics. By not having to make space for hands within tissues like a lung, surgeons can use robotics to minimize patients’ blood loss, risks of infection, and time required to heal.
It’s no surprise that robotic surgeries offer improved health outcomes when compared to traditional surgeries; these may include fewer complications, reduced levels of pain, and less likelihood of cancer returning. As such, the rates of further treatments for these patients, such as blood transfusions and opioid prescriptions, are extremely low. Not only do these outcomes benefit patients, but they can also reduce long-term healthcare costs.
Dr. Hanna’s Journey in Robotic Surgery
Dr. Hanna is a thoracic surgeon at St. Joe’s who regularly performs surgical procedures to treat chest conditions such as lung cancer, esophageal cancer, and more. Traditional operations for these conditions tend to be quite invasive and pose a large array of risks and complications, but Dr. Hanna has used robotics to transform the landscape of this care and minimize the risks of these procedures.
As the pioneer of several cutting-edge robotic surgeries, Dr. Hanna is a national leader in this field. He and his team are dedicated to advancing research and innovation within thoracic surgery, performing operations that were long believed to be impossible.
Dr. Hanna’s interest in robotic surgery first arose when he watched the first robotic lung surgery ever performed in Canada back in 2011, the same year that the Marta & Owen Boris Foundation gifted St. Joe’s with their first surgical robot.
“Immediately in that moment, I knew that this surgery was better than anything else that was available,” said Dr. Hanna. “When I joined St. Joe’s, I had the goal of creating a lung cancer robotics program here and performing these types of operations. Now, I’m proud to say that we have the largest program of its kind in the country.”
Throughout his time at St. Joe’s, Dr. Hanna and his team have improved the techniques used in robotic lung cancer surgeries, helping to make them even less invasive for patients. In the fall of 2024, our Hospital reached a remarkable milestone by treating the 1000th patient to receive this type of surgery, a man named Graham Ross.
“I’m lucky I live in this community where the robotic surgery that can take care of this issue for me is available,” said Graham. “I was quite amazed at how well I felt after the surgery. I was on my way home within 24 hours, and after a week and half I was breathing better. I’m looking forward to a future where I can be with my grandchildren again on a regular basis.”
Lung cancer isn’t the only medical condition that Dr. Hanna and his team have used robotics to treat. In 2022, Dr. Hanna performed the first fully robotic esophagectomy in Canada—a procedure that treats esophageal cancer, a condition associated with very high mortality rates. This groundbreaking operation was performed at St. Joe’s, further cementing the hospital as a leader in robotic surgeries.
The Future of Robotics Surgery at St. Joe’s
At St. Joe’s Hamilton, Dr. Hanna is dedicated to leading robotic surgery research. He and his team of researchers have contributed over 51 peer-reviewed publications to surgical literature. Through these contributions, Dr. Hanna is introducing robotic surgery techniques to medical teams all around the world, improving health outcomes for countless patients. Dr. Hanna is particularly interested in researching how artificial intelligence (AI) can be used in combination with robotics for better patient outcomes.
“AI helps us do things that humans alone aren’t capable of,” said Dr. Hanna. “Your GPS can notify you about a traffic jam so far away that you can’t even see it yet, and suggest an alternate route for you to take in real-time. In the case of lung surgery, there are times when the human eye can’t see intricate parts of the lung anatomy, but an AI program can. This means that surgeons can remove the cancer and keep the healthy tissue with a higher degree of precision.”
St. Joseph's Healthcare Foundation works with generous donors and grateful patients to support robotic surgery through philanthropy. Of the 10 types of robotic surgery that our Hospital offers, only 3 of them are funded by OHIP—the other 7 rely on funding from donors to ensure that patients can access this innovative care. The robotic lung cancer operations that Dr. Hanna performs are just 1 of these 7 that aren’t yet publicly funded.
St. Joseph's Healthcare Foundation has launched a $20 million fundraising campaign to help bring an additional surgical robot to St. Joe's. With it, the Hospital plans to double its volume of robotic procedures so they can help more patients, discover new procedures and continue investigating the power and the promise of robotic surgery. To learn more and make a donation, please visit the Foundation website here.