Breaking new ground in facial reconstruction surgery
St. Joseph’s Corey Moore, MD, and Louis Ferreira, PhD, have developed a ground-breaking surgical technique using robotic technology to improve the lives of people with skin cancer.
Corey Moore, MD, and Louis Ferreira, PhD, consider themselves to be work brothers. They joke that they have been around St. Joseph’s longer than some of the furniture, having completed their training and launched their careers at the hospital.
During the past two decades, the renowned surgeon and researcher have collaborated more than once to better support people in their care. With their latest research collaboration, they have developed a ground-breaking technique using robotic surgery to improve the lives of people with skin cancer. And it’s completely funded through donor support.
Thousands affected
Skin cancer is one of the most common types of cancer in Canada. In 2024, it was projected that more than 80,000 Canadians would be diagnosed with it. And rates of have been on the rise during the past 25 years, but survival rates are high – if it’s caught and treated early. Dr. Moore, who is an otolaryngology-head and neck surgeon, says that today, skin cancer dominates his practice.
For some, treatment for skin cancer involves surgical removal of a part of their face, often their nose or ear, to eliminate the cancer cells, followed by the painful process of reconstruction.
“It’s important for us to reconstruct the defects we create as we aim to remove cancer from a person’s body,” says Dr. Moore, who also serves as St. Joseph’s Site Chief of Otolaryngology-Head and Neck Surgery and Division Chief of Facial Plastic Surgery.
Reconstructing a nose or an ear is a complex procedure that takes artistry, technical skill and time. It’s intricately performed by a surgeon who uses a scalpel and drill to replicate the missing part with the patient’s cartilage, bone and skin. According to Dr. Moore, it’s a challenge to perfect and lengthens the surgery duration and recovery for the patient.
Translational research
Searching for a solution to improve the process, Dr. Moore turned to Ferreira who is a renowned biomechanical engineer and uses robots in his work.
“We design and use robots to augment the work of the surgeon and create solutions,” says Ferreira. “This isn’t about replacing the surgeon. We are mixing surgical planning methodology with engineering and production methods to make a machine which shapes cartilage to make an ear,” he adds. Ferreira believed that a robot could help to improve these techniques.
Under Ferreira’s leadership, Corey Smith, PhD, a postdoctoral fellow designed the robotic system, programmed the robot and created the study protocol to carry out testing.
The team then took a three-dimensional scan of a healthy ear and created a computer model of it. The robot then shaped a piece of donor cartilage until it became a near exact match to the healthy ear. The process has been repeated several times and using different body parts. Currently, it takes 13 minutes for the robot to carve an ear. That’s compared to the 70+ minutes it takes a surgeon to hand carve it.
“We’ve performed ear, nose and facial reconstruction with cadaveric specimens,” says Smith.
Excited about the results and their published papers, Dr. Moore and Ferreira are hopeful that with donor support, the process can be moved into clinical practice soon.
“This is a groundbreaking technique that we have developed,” says Dr. Moore. “And it’s the pure definition of translational research.”
The difference donors make
“These kinds of projects wouldn’t move forward without support from donors through the Foundation,” says Ferreira.
“We do this because we know we have a solution and that at some point we will bring that solution to the operating room,” he adds, emphasizing the important impact of donor support.
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