Georg Nollert

The Hybrid Operating Room

The integration of interventional and surgical techniques is demanding a new working environment for an interdisciplinary cardiovascular team: the hybrid operating room, where angiographic imaging capabilities are integrated in an operating suite. A deep understanding of the clinical applications, the current and future technology, and their implications on workflows is needed for a sound room design.

Flat-Panel CT and the Future of OR Imaging and Navigation

The development of minimally invasive techniques and rapid progress in surgery require integration of advanced imaging capabilities into operating theaters. The setup of a fixed imaging system in an operating theatre where interventional and open procedures can be combined is called a hybrid operating room (OR).

The Cardiovascular Hybrid Operating Room

Recent developments in vascular and cardiac care have led to new therapies integrating transcatheter techniques into surgery. To enable these procedures, operating rooms (ORs) with integrated X-rays imaging capabilities must be installed. These hybrid ORs need—beyond surgical equipment—high-end imaging equipment equivalent to angiography devices used in interventional radiography and cardiology. Imaging devices have long been used in operating theatres. Mobile C-arms, ultrasonography, and endoscopy are the standard of care for many operations. The idea of hybrid ORs is approximately 20 years old, introduced shortly after the initiation of endovascular procedures (Fogarty 1991). However, new devices, more complex transcatheter techniques, and longer procedures demand high-powered equipment to visualize thin guide-wires, quantify small vessel diameters, evaluate delicate anastomoses, and detect endoleaks in the OR. Because of their size and complexity, these integrated endovascular suites—or hybrid ORs—require special considerations, planning, and design, as well as new skills learned by the team. Guidelines on hybrid ORs are currently missing but are under development by multidisciplinary teams.