Journal of Surgery and Interventional Radiology

Hybrid operating room (Hybrid OR)

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A hybrid operating room is an advanced surgical environment that integrates traditional surgical capabilities with sophisticated imaging technologies, such as fixed C-arms, computed tomography (CT) scanners, and magnetic resonance imaging (MRI) systems. This integration facilitates a range of procedures, from conventional open surgeries to minimally invasive interventions, enhancing surgical precision and patient outcomes.

The combination of high-quality imaging within the OR allows for real-time visualization of intricate anatomical structures, which is particularly beneficial in procedures requiring detailed navigation, such as cardiovascular surgeries. For instance, in endovascular aneurysm repair, the use of intraoperative imaging enables precise placement of stents, reducing the need for more invasive open surgeries. ?

In neurosurgery, hybrid ORs provide the capability to perform complex procedures with enhanced accuracy. The availability of intraoperative imaging assists in the real-time assessment of surgical progress, potentially reducing the need for subsequent interventions. ?

The design and implementation of a hybrid OR require meticulous planning. The room must be spacious enough to accommodate the surgical team, imaging equipment, and support staff, often necessitating a minimum area of 70 square meters, including a control room. Structural considerations include the installation of lead shielding to protect against radiation and reinforcement of floors or ceilings to support the substantial weight of imaging devices, which can range from 650 to 1,800 kilograms.

Effective workflow within a hybrid OR demands collaboration among various stakeholders, including surgeons, anesthesiologists, nurses, and radiology technicians. Early involvement of these parties in the planning process ensures that the room design meets diverse clinical requirements and optimizes patient care. Additionally, the integration of appropriate lighting systems is crucial; surgical lights must provide adequate illumination without interfering with imaging equipment, and ambient lighting should be adjustable to accommodate procedures like fluoroscopy or endoscopy.

The hybrid operating rooms represent a significant advancement in surgical practice, offering the versatility to perform a wide array of procedures with enhanced precision. The successful implementation of such environments hinges on comprehensive planning and interdisciplinary collaboration, ultimately contributing to improved surgical outcomes and patient safety.