Brief History of Thoracic Surgery in TorontoThoracic Surgery in Toronto began as a subspecialty of General Surgery on Ward “C” of the Toronto General Hospital over 70 years ago with the pioneering efforts of Dr. Norman Shenstone and Dr. Robert Janes. Indeed, until the development of the Shenstone/Janes tourniquet in 1932, the safety of lobectomy for suppurative diseases of the lung was in question. The tourniquet developed in Toronto controlled intraoperative hemorrhage, avoided postoperative fistulae and decreased mortality. Because of the popularity of this tourniquet, Toronto quickly became a centre for Thoracic Surgery in North America. Dr. Shenstone was ultimately elected to Honorary membership in the American Association for Thoracic Surgery and fostered the training of young aspiring General Surgeons in the area of Thoracic Surgery.
Dr. Janes, the other member of this team, ultimately was appointed Professor and Chairman of Surgery at the University of Toronto and Chief of Surgery at Toronto General Hospital. His disciple was Dr. Fredrick Kergin who also rose to the ranks of Professor and Chairman of Surgery at the University of Toronto and as Chief of Surgery continued the development of Thoracic Surgery at the Toronto General Hospital. Dr. Kergin developed original techniques and operative procedures still bearing his name – the Kergin thoracoplasty and bronchoplasty are examples of this. He was recognized internationally and ultimately was elected President of the American Association of Thoracic Surgery (AATS).
Dr. F. Griffith Pearson, a disciple of Dr. Kergin, followed in his footsteps and contributed extensively to Thoracic Surgery’s development as a specialty worldwide with the popularization of mediastinoscopy, the development of techniques of modern tracheal surgery and the treatment of recalcitrant esophageal reflux with the introduction of the Collis-Belsey procedure, (the “Pearson Operation”). He also served as President of the AATS.
In 1966, the first Thoracic Surgical Service at the University of Toronto was instituted at the Toronto General Hospital under the leadership of Dr. Pearson. Drs. Norman Delarue and Robert Henderson were appointed as the first associates on the Service.
Subsequent to this, a whole litany of internationally recognized thoracic surgeons have contributed to the development of general thoracic surgery in Toronto. In 1983, following 20 years of laboratory work and partial clinical successes, the Toronto Thoracic Surgical Group under the leadership of Joel Cooper performed the first successful human lung transplant operation, further confirming Toronto’s preeminence.
The training program in Thoracic Surgery instituted by Dr. Pearson and ultimately recognized by the Royal College of Physicians and Surgeons of Canada as a separate specialty has been a template for training programs throughout North America and indeed the world. The majority of graduates of the “Toronto Program” are now international leaders in the field of general thoracic surgery and lead their own thoracic programs throughout North and South America, Europe, and Asia. In 1990, because of the increasing popularity of this program, in order to train more surgeons, a second unit was developed at the Mount Sinai Hospital and more recently a third unit has been opened at St. Joseph’s Health Centre. All of these units have contributed to the training of general thoracic surgeons who now populate most of Canada and indeed North America.
Ever since its inception, the Thoracic Surgical Services at the University of Toronto have fostered the concept of translational research. The Thoracic Surgical Research Laboratories have made seminal contributions in the following areas: airway surgery, lung transplantation and lung oncology. As well, the Thoracic Service was the first surgical group in Toronto to participate and lead a North American cooperative group (The Lung Cancer Study Group). Ever since that time, the group has lead in clinical trials of lung cancer treatment in North America. The seminal clinical contributions of the Thoracic Surgical Group include: new operative techniques in the investigation and treatment of the following: tracheal resection, mediastinoscopy, single and double lung transplantation and perioperative management of lung cancer patients.
Since its institution as a separate specialty, the Division of Thoracic Surgery at the University of Toronto has been led in succession by Drs. F. Griffith Pearson, Joel Cooper, Martin McKneally, Thomas Todd, Robert Ginsberg, and Shaf Keshavjee. Presently the Chair is Dr. Tom Waddell.