P R E S S   R E L E A S E

The Faculty of Medicine of The Chinese University of Hong Kong has pioneered in the development of minimal access cardiothoracic surgery which has been proven to be of great benefit to many patients requiring chest surgery.  This new approach greatly reduces the pain arisen from surgery and markedly shortens recovery.

With the advances in minimally invasive surgery, cardiothoracic surgery is experiencing a revolution with regard to the conduct of operative procedures.  Many surgeons have come to recognize that the process of obtaining access into the chest is sometimes more traumatic than the procedures to be performed.  This is because the traditional incision to gain access into the chest (thoracotomy) is an extremely painful incision.  It consists of a long incision starting from the back, curving around the chest to the front.  In addition, major chest wall muscles have to be divided and most importantly, the ribs have to be widely spread in order to gain access into the chest.  The sum effect is that the patient who had this incision would take a long time to recover.  Postoperative complication like chest infection is frequent because the patient has difficulty to cough and clear the sputum due to wound pain.  Moreover, pain from this incision often persists even after the wound has healed.  Many patients who had this incision would testify that whenever the weather changes, they could feel pain in their wound.  Because of this, recovery following traditional chest surgery is often slow and it is not uncommon for patients to stay in hospital for over ten days and not able to return to work for many weeks.  Video-assisted thoracoscopic surgery (VATS) changes this picture completely.  The same chest operation can now be performed through a few small incisions.  Major muscles don't need to be cut and ribs not spread.  Postoperative pain is substantially less.  Patients can now go home a few days following major chest surgery.  This surgical approach has a profound positive effect on healthcare economics by shortening hospital stay and allowing patients to return to work earlier.

Heart Surgery

In addition to lung surgery, the Chinese University has also pioneered in the development of minimal access heart surgery.  Aortic valve replacement and aortic root replacement can now be safely carried out through a partial sternotomy, instead of through a conventional full sternotomy and thus, the trauma to body tissues and postoperative pain are greatly reduced.  Minimal access surgery can also be applied to patients requiring coronary artery bypass grafting.  This can be carried out without the use of a heart-lung machine (beating heart surgery), and avoiding the attendant risks of the heart-lung machine to the patients.  The Faculty of Medicine of The Chinese University of Hong Kong performed the first case of beating-heart coronary artery bypass surgery in Hong Kong in 1996.

Training

Although this new surgery has many advantages to patients, it is very demanding on the surgeons.  The operator is required to learn a whole new set of manual skills.  The Chinese University has played a pivotal role in training surgeons at home and from abroad.  The first training programme which enabled thoracic surgeons from Mainland China to come to the Prince of Wales Hospital for short-term training was launched in 1994.  These surgeons then returned to the mainland and started practicing this new surgery method.  So far thirteen thoracic surgeons from different cities in Mainland China were trained.  The Chinese University has also designed a training model to facilitate surgeons to acquire the new skills of beating heart surgery, which has recently received the U.S. Patent.

International Recognition

The Faculty of Medicine of The Chinese University of Hong Kong pioneered in the development of this new innovative surgery and we were among the first group of surgeons in the world to perform many complex minimal access procedures in the chest.   Over 1,500 video-assisted thoracic surgical procedures so far have been carried out at the Prince of Wales Hospital with overall excellent results.  These include operations for a variety of chest conditions—from the diagnosis of pleural effusion, biopsies of mediastinal and lung masses to major lung resection for early lung cancer, excision of mediastinal tumors and treatment of excessive hand sweating (palmar hyperhidrosis).  The Prince of Wales Hospital is internationally recognised as a centre of excellence for carrying out these new procedures.  Much of these recent developments is captured in a book entitled Minimal Access Cardiothoracic Surgery, published by W.B. Saunders and edited by Professor Anthony Yim Ping-chuen, Chief of Cardiothoracic Surgery at The Chinese University of Hong Kong.  This book is widely acclaimed as the standard reference textbook on this topic.  Professor Yim has been asked to operate and lecture on this subject in many countries.  He serves on the Editorial Boards of several major international medical journals and has been invited as a Visiting Professor to several institutions around the world including the People Liberation Army General Hospital (301) in Beijing, the University of Toronto in Canada and the University of Oxford in UK.