Hybrid operating room

A hybrid operating room is a surgical theatre that is equipped with advanced medical imaging devices such as fixed C-Arms, CT scanners or MRI scanners. These imaging devices enable minimally-invasive surgery, which is less traumatic for the patient. Minimally invasive means that the surgeon does not need to cut the patient open completely in order to access the body part he wants to perform surgery on, but can insert catheters or endoscopes through small holes. Though imaging has been a standard part of the OR for a long time in the form of mobile C-Arms, ultrasound and endoscopy, these new minimally-invasive procedures require imaging techniques that can visualize smaller body parts such as really thin vessels in the heart muscle and can be facilitated through intraoperative 3D imaging.

Hybrid operating rooms are currently used mainly in cardiac, vascular and neurosurgery, but could be suitable for a number of other surgical disciplines.

The repair of diseased heart valves and the surgical treatment of rhythm disturbances and aortic aneurysms can benefit from the imaging capabilities of a hybrid OR. Hybrid Cardiac Surgery is a widespread treatment for these diseases.

Also, the shift towards endovascular treatment of abdominal aortic aneurysms pushed the spread of angiographic systems in vascular OR environments. Particularly for complex endografts, a hybrid operating theater should be a basic requirement. Also, it is well-suited for emergency treatment.

Some surgeons do not only verify the placement of complex endografts intraoperatively, they also use their angiography system and the applications it offers for planning the procedure. As anatomy changes between a preoperative CT and intraoperative fluoroscopy because of patient positioning and the insertion of stiff material, a much more precise planning is possible if the surgeon performs an intraoperative rotational angiography, takes an automatic segmentation of the aorta, places markers for the renal arteries and other landmarks in 3D and then overlays the contours on 2D fluoroscopy. This guidance is updated with any change in C-Arm angulation/position or table position.

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Wikipedia