Hybrid operating theatres combine conventional surgical equipment with a high-performance imaging system that produces three-dimensional images of the patient’s body during surgery and displays them on screens inside the operating theatre.
- Imaging system: During the operation, a robot arm connected to the imaging system rotates around the patient and delivers three-dimensional images of the inside of the body.
- Team: A team of up to 20 people work inside the hybrid operating theatre – including surgeons, anaesthetists, operating theatre nurses, cardiology technicians and implant experts.
- Operating table: The operating table can be rotated in all directions and communicate with the imaging system. The table’s movements are synchronised with the imaging system’s robot arm.
New techniques, greater teamwork
The key advantage of hybrid operating theatres is that they can be used to perform open and minimally invasive surgery, or a combination of both, and also provide high-precision radiological imaging during the procedure. This paves the way for entirely new interdisciplinary therapeutic concepts that are faster, safer and less traumatic for patients, because everything can be carried out simultaneously in one place. Particularly in the case of vascular emergencies, it is possible to convert a minimally invasive operation into an open operation in just a few minutes, without the patient having to be moved to another theatre at such a critical time.
Various examinations can also be incorporated into the procedure. For instance, the surgical team can measure and evaluate the patient’s blood pressure, blood flow rate, the amount of blood being transported through the heart and the elasticity of the vessels. This saves the patient from undergoing time-consuming individual examinations, or being transported to various diagnostic devices during the operation.
Setting up a hybrid operating theatre is a very challenging task: not only does the imaging unit require additional space, but such theatres are also staffed by more personnel. Depending on the complexity and difficulty of the operation, a team of up to 20 people are involved, including anaesthetists, vascular surgeons, endovascular specialists, operating theatre nurses, cardiology technicians and supporting personnel such as experts from implant manufacturers.
Hybrid imaging techniques for optimised heart surgery
Minimally invasive treatment methods have become an established part of cardiology. These include hybrid heart operations involving the use of cardiac catheters. Ultrasound and x-ray imaging are usually used at the same time. Each technique has different strengths: x-ray images make it possible to display bones, instruments and catheters, whereas ultrasound is ideal for showing soft tissue structures, such as heart valves. Since 2014 Hirslanden has been synchronising and fusing 3D ultrasound and x-ray images in real time, so that all the elements can be displayed live and simultaneously on a screen. This approach also enables the operator to interact directly with the images, which makes it easier to plan and carry out complex surgical procedures. The image-guidance tool involved is called an Echonavigator and it ensures high degree of accuracy and synchronisity.
Highly specialised operations
Among other things, hybrid operating theatres are used for highly specialised procedures such as aortic valve replacement, bypass operations, treatment of cardiac septum defects, aneurysms (swollen arteries) and stenosis (narrowing of blood vessels), some of which are performed using minimally invasive techniques.