Hybrid Operating Room & Cardiac Catheterization Suite Imaging Systems: Angiography, iMRI, CT, Fluoroscopy. Comparison of Hybrid OR Imaging Systems. Philips, Siemens, GE, Toshiba, IMRIS. Zeego, Artis Zee, FD20, FlexMove, Allura, Discovery IGS, Infinix. Interventional Radiology, Cardiovascular, Cardiothoracic, EP.
Diagnostic Imaging Systems for Hybrid Surgical Suites
The Hybrid Operating Room includes a dizzying assortment of infrastructure, with the imaging equipment serving as the centerpiece.The most common imaging modality to be used in Hybrid ORs is a C-Arm. Expert consensus rates the performance of mobile C-arms in Hybrid ORs as insufficient, because the limited power of the tube impacts image quality, the field of view is smaller for image-intensifier systems than for flat-panel detector systems and the cooling system of mobile C-Arms can lead to overheating after just a few hours, which can be too short for lengthy surgical procedures or for multiple procedures in a row, that would be needed to recover the investment in such a room.
Fixed C-Arms do not have these limitations, but require more space in the room. These systems can be mounted either on the floor, the ceiling, or both if a biplane system is chosen. The latter is the system of choice if pediatric cardiologists, electrophysiologists or neurointerventionalists are major users of the room. It is not recommended to implement a biplane system if not clearly required by these clinical disciplines, as ceiling-mounted components may raise hygenic issues: In fact, some hospitals do not allow operating parts directly above the surgical field, because dust may fall in the wound and cause infection. Since any ceiling-mounted system includes moving parts above the surgical field and impairs the laminar airflow, such systems are not the right option for hospitals enforcing highest hygienic standards.
There are more factors to consider when deciding between ceiling- and floor-mounted systems. Ceiling-mounted systems require substantial ceiling space and, therefore, reduce the options to install surgical lights or booms. Nonetheless, many hospitals choose ceiling-mounted systems because they cover the whole body with more flexibility and – most importantly – without moving the table. The latter is sometimes a difficult and dangerous undertaking during surgery with the many lines and catheters that must also be moved. Moving from a parking to a working position during surgery, however, is easier with a floor-mounted system, because the C-arm just turns in from the side and does not interfere with the anesthesiologist. The ceiling-mounted system, by contrast, during surgery can hardly move to a parking position at the head end without colliding with anesthesia equipment. In an overcrowded environment like the OR, biplane systems add to the complexity and interfere with anesthesia, except for neurosurgery, where anesthesia is not at the head end. Monoplane systems are therefore clearly recommended for rooms mainly used for cardiac surgery.
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Imaging Systems for Hybrid Operating Room & Cath Lab Suites
Additional 'hybrid' concepts that integrate advanced image guidance modalities into the surgical environment have recently begun to be developed in selective medical centers throughout the world. These include the seamless integration of various forms of magnetic resonance imaging (MRI), positron emission tomography (PET), computed tomography (CT), and ultrasound and radiographic imaging devices as part of the surgical room. Each involves a re-examination of workflow, infection control, various forms of shielding and safety issues.
J.M. Keckler Medical Co. - Hybrid Operating Room Consultants
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