TORONTO — Surgeons in Toronto are proving that life-saving brain procedures no longer require a doctor to be in the same room — or even the same city — as the patient.
Specialists at St. Michael’s Hospital have successfully completed 10 brain angiograms using a robotic system controlled remotely over a secure fibre-optic internet connection. The breakthrough is being hailed as a potential turning point for stroke treatment in rural and remote communities across Canada.
Dr. Vitor Mendes Pereira, an interventional neuroradiologist leading the project, says speed is critical when dealing with strokes.
“Time is everything,” he said. “If we can treat patients closer to where they live instead of flying them hundreds of kilometres, we can dramatically improve outcomes.”
How the technology works
From a specialized control room, surgeons operate a robotic system that guides a catheter through blood vessels in the brain. A medical team remains physically present with the patient, while the surgeon communicates continuously through live audio and video links.
Over the course of testing, doctors gradually increased the distance between surgeon and patient — from operating in the same room to performing procedures from several kilometres away. In the most recent case, a surgeon operated from St. Michael’s Hospital while the patient was at St. Joseph’s Hospital, roughly six kilometres away.
Hospital technologists say extensive testing has ensured safety protocols are in place should connectivity issues arise, allowing teams to respond instantly if a problem occurs.
A world-first procedure could be next
The team is now seeking approval from Health Canada to attempt a far more complex operation: a remotely performed endovascular thrombectomy, a procedure used to remove blood clots during severe strokes.
If approved, the surgery would be carried out on a patient in Sault Ste. Marie, nearly 500 kilometres from Toronto — making it the first remotely performed thrombectomy anywhere in the world.
Dr. Michael Kutryk, chief of cardiology at Sault Area Hospital, says patients in the region currently have to be airlifted to larger centres, often losing precious time.
“Transport delays can mean permanent disability or worse,” Kutryk said. “This technology could allow patients to be treated locally, hours earlier, and surrounded by their families.”
Why rural Canada stands to benefit most
Sault Ste. Marie sees roughly a dozen stroke cases each year that require thrombectomy — not enough to justify a full-time specialist, but enough to make access a serious challenge.
Remote robotic surgery could bridge that gap, giving smaller hospitals access to top-tier expertise without relocating patients.
Health professionals say the model could also reduce long-term health-care costs by preventing stroke-related disability, which often requires years of rehabilitation and support.
The cost challenge
The technology does not come cheap. Surgical robots can cost between $1 million and $3 million, with additional expenses for single-use surgical equipment. Rural hospitals already under strain may struggle to justify the investment.
Dr. Sarah Giles, president-elect of the Society of Rural Physicians of Canada, cautions that many rural facilities are still fighting to maintain basic emergency services.
“Before we talk about cutting-edge robotics, we need to make sure the fundamentals of rural health care are stable,” she said.
A long-term investment, doctors say
Despite the costs, researchers believe the technology will ultimately pay for itself. Dr. Mendes Pereira estimates that a single robot could save the health-care system up to $2 million annually by reducing long-term stroke care costs if used regularly.
“This is about buying time,” he said. “And in medicine, time saves lives.”
