Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Since June 2013 a hybrid operation theatre is used interdisciplinary in the department for surgery of Ulm University. In this operation theatre a floor-based flat panel c-arm, which is mounted on a robotic arm that can be controlled by the surgeon in a sterile environment, is linked to the operating table. Furthermore for the first time it was possible to integrate a navigation system in this setting. ⋯ In these anatomical regions the excellent image quality and large field of view of the robotic flat panel detector based 3D imaging combined with an intraoperative navigation system is a huge advantage. The system can also be used for complex fractures of the extremities. In the future there will be an integration of further imaging modalities and referenced holding devices in this setting.
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Review
[Hybrid operation theatre from the point of view of cardiac surgery. The future for the heart team].
Nowadays, increasing numbers of procedures jointly conducted by cardiac surgeons and cardiologists are performed as minimally invasive surgical procedures or interventions. Transcatheter aortic valve implantation, endovascular aortic aneurysm repair and a large variety of hybrid procedures for congenital heart disease have become current standards. Some of these hybrid procedures were shown to improve the therapeutic safety and efficacy, effects particularly true for high-risk patients and complex interventions. ⋯ This article describes the technical prerequisites required for a hybrid operation theatre as well as indications and rationales for hybrid procedures conducted in this environment. It is likely that the indications for cardiovascular hybrid procedures will continue to be expanded and that the hybrid operation theatre may become a laboratory for developing innovative approaches in the cardiovascular field. Therefore, the hybrid operation theatre will not only be the working environment for hybrid surgeons and interventionalists but also help to evolve their future.
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The integration of hybrid operation theatre into neurosurgical and neuroradiological routines is revolutionizing in particular the management of neurovascular emergencies, such as subarachnoid aneurysmal hemorrhage (SAH) or ruptured arteriovenous malformations. ⋯ As this new concept requires organisational changes throughout the entire patient management, a change of mindset is also needed at the institutional level in order to attain maximum benefits from such a setting.
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Demographic development leads to an increase in vascular interventions due to the increase in elderly and multimorbid patients. The aim of this study was to demonstrate the open interventional therapy options and their influence on staff and patients which have become possible due to the introduction of angio-hybrid operations including 3-D imaging Dyna-CT. ⋯ Using angio-hybrid operational procedures complex interventions can be carried out with more safety for patients and personnel. The implementation of 3-D imaging Dyna-CT offers additional interesting options for complex aortic procedures.