3. Patient demand, changing healthcare landscape
demand for a new working environment(Hybrid OR)
Vascular
Surgery
.
4. Plans Equipment Imaging OR table
Key success factors for building an advanced
cardiovascular hybrid room:
Clinical Procedure
Requirement Assessment
Planning
Project Management
Partner Management
5. Cardiovascular Hybrid Operating Room
Imaging and surgical equipment in one room
Monitors incl.
catheterization
software
3D C-Arm
with 80 - 100kW
Sterile environment
OR imaging table
e.g. floating table top or
traditional breakable OP-
table
Anesthesia equipment
Radiation shielding
6. Define space based on facility needs address costs
Build a functional team including physicians, nurses, technicians,
infection control, environmental services and vendors
Define roles and responsibilities of all parties involved (who owns
project coordination) ? Hybrid surgery program director
Decide on imaging equipment and table
Define suppliers/vendors for other equipment
Always start by identifying imaging equipment location
Define all other equipment locations and requirements, i.e. ceiling
lights ,surgical and video integration surgery workflow
Iterative verification of coordination and planning of all vendors in
CAD
Reviews of solutions with user group/team (verify that needs are
met)
Sign-off concept (vendors and users!!!)
Anticipate Future Technologies
Exemplary process in a Hybrid OR Project
7. Lighting
Displays/Monitors
Imaging (Live, Reference, 3D, PACS…)
Video Integration (Endo, Ultrasound, Microscope, Navigation….)
Communication and Digital Data Integration
Audio (wired, wireless, etc.)
Control Room to Operating Room
Acoustics
Equipment Reaches especially pendants/utilities
Point of use
Park positions
Ceiling and Floor Structure Requirements
Mass grid option (alignment of all lots!)
Renovation Issues, incl. HVAC and electrical installation
Use proper CAD blocks for all equipment and create one single “Masterplan”
Topics to be discussed in Every Hybrid OR
Project
13. Cardiovascular Surgery Hybrid Program (Hoag Model)
led by endovascular cardiac surgeon
Endoaortic /open aortic surgery program
Surgical valve/transcatheter valve program
Hybrid maze program
Surgical revascularization/hybrid revascularization program
Hansen robotic endovascular program)endovascular robotics)
Da Vinci robotic surgical program
Image guided surgery program
MRI /3D CT cardiac imaging program
Echocardiography /Intravascular ultrasound imaging program
Carotid surgery/ carotid stent program
Peripheral vascular surgery program
Vascular laboratory program
Image guided surgery research program collaboration with Siemens
21. Trans-Catheter Aortic Valve Program:
3D Dyna CT performed in a
hybrid OR to accurately size
and deploy trans-catheter
valves
procedural details
22. Endo Aortic Program: CT Fusion Registration for EVAR
Guidance In a Hybrid Operating Room Setting.
Preoperative CT scan is
exported to the hybrid operating
room and fused with a non
contrast Dyna CT scan obtained
in the operating room .
Fusion technology of 2 CT
volumes enables real time
navigation and placement of
sheaths, wires and devices
without need for contrast
injection.
Co registration of IVUS with
Fused CT /fluoro images can
further decrease use of contrast
in renal impaired patients
requiring EVAR.
23. Registration of 3D CT with fluoroscopy with IVUS
integration
.A marker is placed
perpendicular to the
IVUS probe (arrow) on
the patient under
fluoroscopic guidance to
correspond to the
location of the renal
vessels ostium as
determined by IVUS
imaging co registered
with fusion
CT/fluoroscopy.
30. Functional Imaging
Prototype Version – Not commercially available
Blood Velocity Vectors
Volumetric Blood
Velocity Magnitude
Blood Pressure on
Wall
Blood Flow
Streamlines
31. Model automated modeling of mitral valve
*Not commercially available. Due to regulatory reasons its future availability cannot
be guaranteed.
32. automated modeling of aortic valve
*Not commercially available. Due to regulatory reasons its future availability cannot
be guaranteed.
33. Perceptive technology: true understanding of form, flow and function
*Not commercially available. Due to regulatory reasons its future availability cannot
be guaranteed.
34. 3D CT mitral valve analysis software for image guide mitral valve
surgery/intervention program.
37. OUR GOAL: Adding life to years …OUR GOAL: Adding life to years …
38. In summary: Involve all stakeholders as early as
possible in the project!
Discuss layout/concept with all
involved parties on hospital and
vendor side
Involved parties may be:
Scrub nurses
Business manager
Planning department
Project Manager
Other vendor representatives
Surgeons/interventionalists
Technical director
Hygienist
Anesthetist
And now we come to the second big part of my presentation: Planning.
No matter if refers to systems, tables, application training or the room plans themselves – it is a crucial topic. We will focus on this in more detail tomorrow during our deidcated OR session in Leipzig. But I will still touch on two topics – room planning and applications training.
Why is room planning so important?
Imaging company provides all spec requirements for their equipment.
How it can be in an OR.
High level review of the entire space…point out the 4 different areas.
