When Dr. Sean Cleary tragically passed away during a triathlon in Barrie on a Sunday morning in August, the medical community lost more than a skilled surgeon. They lost a visionary leader committed to bridging a significant gap in Canadian healthcare — one that affects countless patients and leaves future surgeons at a disadvantage.

At 52, Cleary was dedicated to addressing a pressing issue: Canada's lag in adopting robotic surgery technology. This technology is known for reducing recovery times, lowering infection rates, and offering minimally invasive treatment options. His death signifies not just a personal loss but the silencing of a strong advocate for transformative change in Canadian medical training.

The Visionary Surgeon

Dr. Sean Cleary's career was a testament to surgical excellence. As the chair of the division of general surgery at the University of Toronto, he balanced clinical practice with teaching and research, impacting many lives through his work at Princess Margaret and Toronto General hospitals.

His career took a pivotal turn during his seven-year tenure at the Mayo Clinic in Minnesota from 2016 to 2023. There, he observed how American medical institutions had embraced robotic surgery, creating training opportunities that were scarce in Canada.

"I am struggling to accept what has happened," wrote Dr. Carol Swallow, chair of the department of surgery at U of T, in tribute to her colleague. "We have all lost a fine human being whose like we will not see again. Sean has touched the lives of many of us – as a clinical colleague, a teacher, a mentor, a supervisor, a confidential advisor, and a friend."

Upon his return to Toronto two years ago, Cleary brought not just expertise but a mission: to ensure Canadian medical students could compete on equal footing with their American counterparts.

Canada's Robotic Surgery Deficit

The statistics paint a stark picture of Canada's position in modern surgical technology. As of 2022, Canada had only 30 surgical robots across 14 cities, performing about 6,000 operations annually. In contrast, the United States conducted over 2.6 million robotic surgeries in 2024 alone.

This disparity isn't merely about numbers—it's about patient outcomes. Robotic surgery provides significant advantages over traditional methods, including:

• Faster recovery times
• Lower infection risks due to minimally invasive procedures
• Greater precision through advanced technology
• Reduced scarring and fewer post-operative complications

Moreover, this technology gap creates geographic disparities within Canada. Patients in smaller cities and rural areas face longer waits or must travel far to access robotic surgery, while urban centers struggle with limited capacity.

The shortage impacts not just current patients but the entire trajectory of Canadian medical excellence. As Cleary noted to Medscape, the limited availability of robotic systems means fewer surgeons gain experience with the technology, creating a cascading effect that impacts training for the next generation.

The Training Dilemma

Beyond headlines about wait times and healthcare funding lies a more insidious problem: Canada's medical students are falling behind their international peers before they even begin practicing.

Cleary identified this as a critical catch-22. With few robots available, there are fewer experienced surgeons to train new students. This cycle means Canadian medical graduates struggle to compete for prestigious fellowships and positions that increasingly require robotic surgery experience.

"Sean was determined to make robotic surgery training widely available to residents and clinical fellows in Toronto, and across Canada, so that they could compete on an even footing with their American-trained counterparts for fellowships and staff positions," Swallow explained.

The implications extend beyond individual career prospects. When Canadian-trained surgeons can't access advanced training opportunities, it affects the entire healthcare system's capacity to provide cutting-edge care. Patients endure longer wait times, and Canada loses talented medical professionals to countries with better training infrastructure.

Cleary's solutions focused on leveraging his Mayo Clinic connections to create training partnerships and expand access to robotic surgery education. His vision wasn't just about bringing more robots to Canada—it was about creating a comprehensive training ecosystem for sustained growth in surgical excellence.

A Leader's Broader Impact

While robotic surgery advocacy defined Cleary's recent work, his influence extended throughout the surgical community. As a leading figure in hepato-pancreato-biliary (HPB) surgery—a specialized field focused on the liver, pancreas, and gallbladder—he shaped practices across North America.

His leadership roles included serving as former president of the Canadian Association of General Surgeons and co-founding the Canadian HPB Association. The Americas HPB Association, where he also served as president, remembered him as "a true visionary whose impact transcended borders and specialties".