• Toshihiro Ogiwara, Tetsuya Goto, Yu Fujii, Yoshiki Hanaoka, Yoshinari Miyaoka, Jun-Ichi Koyama, Kazuhiro Hongo, and Tetsuyoshi Horiuchi.
• Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: togiwara@shinshu-u.ac.jp.
• World Neurosurg. 2022 Nov 1; 167: e710e716e710-e716.

ObjectiveShinshu University Hospital has advanced operating rooms including a mobile computed tomography (mCT) room, Smart Cyber Operating Theater (SCOT) with intraoperative magnetic resonance imaging, hybrid operating room (hOR) with intraoperative image-guided surgery, and conventional operating rooms. We investigated the characteristics of cases assigned to each operating room.MethodsFive hundred forty neurosurgery cases from January 2018 to April 2021 were analyzed. We analyzed the selection of operating room according to pathology, surgical device requirement, and urgency, and we examined associations between operating room characteristics and these factors.ResultsNeurological surgeries were performed in an mCT room, an hOR, a SCOT, and a conventional operating room in 333 (61.7%), 64 (11.9%), 49 (9.1%), and 94 (17.4%) cases, respectively. mCT rooms were more frequently selected than other rooms for vascular/extra-axial tumors, which have a lower need for intraoperative image guidance. Spinal surgeries with segment diagnosis or intraoperative bone removal tended to be performed in the hOR. The rate of SCOT use tended to be higher for intra-axial tumors with poorly circumscribed borders than for vascular/extra-axial tumors. Endoscopic procedures were more frequently performed in the SCOT and mCT rooms than in hORs and conventional operating rooms. Emergency surgeries were often performed in the conventional operating rooms, even in cases where SCOT and hOR seemed suitable.ConclusionsIntraoperative image-guided surgeries were performed according to the characteristics of each operating room best suited for various diseases and operative methods. Further research is needed to prove whether operating room selection improves neurosurgical outcomes.Copyright © 2022 Elsevier Inc. All rights reserved.

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