Before the bright lights of the operating room are turned on and the surgeons and operating room staff are gowned and ready, research conducted at Lawson Health Research Institute has backed many of the surgical innovations and firsts performed at London Health Sciences Centre and St. Joseph’s Health Care London.

On October 5, Lawson hosted a Café Scientifique event where a panel of surgeons who are also Lawson scientists discussed their cutting-edge work. Guests had the opportunity to ask questions as part of an open-forum discussion to gain insights from the speakers, and from one another.

In celebration of Canada’s 150th anniversary as a nation, this event was the second of a two-part series focusing on the future vision for health care in Canada and the legacy that research at Lawson will leave. Research and knowledge-creation have been a hallmark of the various surgical areas at LHSC and St. Joseph’s since their inception, and the relationship between innovation and improving patient care has been an enduring trademark. Surgeon scientists have conducted and published research that has changed clinical practice worldwide.

Hand surgery: How small advances turn into complex surgical achievements

Dr. Bing Siang Gan, Lawson scientist, plastic surgeon, Hand and Upper Limb Centre, St. Joseph's

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Dr. Gan has a particular research interest in the biology and treatment of Dupuytren's contracture and he uses conventional as well as minimal invasive procedures such as needle aponeurotomy and new collagenase enzyme injections to treat patients.

Dr. Gan explained how a better surgical understanding of Dupuytren's contracture combined with an understanding of the underlying gene factors, DNA, RNA, proteins, receptors, and collagen formation of the condition has led to pharmacological treatment options. The next step will be developing treatment options at every stage of Dupuytren's contracture to keep patients away from the operating room.

Transplant organ preservation: The best option may be “Stinky”

Dr. Alp Sener, Lawson scientist, transplant surgeon, Multi-organ Transplant Program, LHSC

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Dr. Sener maintains an active basic sciences and translational research laboratory focusing on gasotransmitter biology and therapeutics. Dr. Sener discussed the need to use “marginal” deceased donor kidneys - those from older donors, younger donors with existing medical issues, and donors post circulatory death – to treat end stage renal disease because due to a lack of donor supply.

Dr. Sener’s laboratory pioneered the use of hydrogen sulphide, a colourless gas with a strong “rotten egg” odor, to prolong organ storage, improve kidney re-perfusion, decrease dangerous inflammatory cells, promote quicker kidney function recovery, greater urine output and improve recipient survival.

Computer-assisted gastrointestinal surgery: Why can’t they see what I see?

Dr. Christopher Schlachta, Lawson scientist, medical director, Canadian Surgical Technologies and Advanced Robotics (CSTAR), LHSC

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Dr. Schlachta’s current research interests are focused on development of computer-assisted surgical techniques and technologies to enhance care and training. Dr. Schlachta demonstrated how computer-assisted technologies in the operating room can enhance communication among surgeons and trainees to produce better outcomes for patients. He is currently partnering with industry to commercialize operating room technology he and a team of engineers at CSTAR have developed.

See more photos from this Café Scientifique on Lawson's Facebook page.

A simple fall can lead to long-term hand problems such as arthritis due to fracturing the scaphoid bone in the wrist. Scaphoid fractures are known to have the highest rate of healing failures. While this bone’s fragile blood supply is commonly thought to be the main reason for why it is difficult to heal, Dr. Ruby Grewal is looking into a different reason – infection. 

Infections are known to cause difficulty in healing bones, but traditional tests for infections in the scaphoid have come up negative. With new advancements in detecting microbial DNA, scientists can now test for ‘clinically undetectable’ infections. 

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In a new study, Dr. Grewal will use microbial DNA test whether or not there are infections in the scaphoid fracture which causes improper healing of the bone.

“The goal of this study is to use advanced DNA sequencing technology to test whether or not we can detect evidence of microorganisms in non-healing scaphoids,” explains Dr. Grewal, Lawson Scientist and Orthopaedic Surgeon at the Roth McFarlane Hand and Upper Limb Centre (HULC) at St. Joseph’s Health Care London.

Finding new causes of improper healing of the scaphoid bone could improve treatments for individuals with these injuries and prevent long-term problems with hand function. These insights into the causes of improper healing could also prevent young patients from developing wrist arthritis.

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From left to right: Normal scaphoid fracture. Scaphoid fracture that is struggling to heal. Scaphoid non-union where the bone has failed to heal.

Dr. Grewal’s study is being funded through the Lawson Internal Research Fund (IRF).

“The financial support provided by Lawson’s IRF is of utmost importance to researchers. These funds will allow our team to embark on a new area of research and test a novel hypothesis,” says Dr. Grewal, “While traditional granting agencies are reluctant to fund completely novel areas of research without pilot data to prove feasibility, the Lawson IRF allows researchers to investigate new theories in a sound scientific manner. Without the ability to test new ideas we cannot innovate and make advancements in health care. Support for this project allows for that.”

Lawson’s IRF is designed to provide Lawson scientists the opportunity to obtain start-up funds for new projects with the potential to obtain larger funding, be published in a high-impact journal, or provide a clinical benefit to patients. Funding is provided by the clinical departments of London Health Sciences Centre and St. Joseph’s Health Care London, as well as the hospital foundations (London Health Sciences Foundation and St. Joseph’s Health Care Foundation).