Marc Bosiers, Dendermonde, Belgium, and Stéphan Haulon Lille, France, debated on the use of fixed vs. mobile hybrid operating rooms for endovascular procedures at the CX Vascular Imaging Course 2011 (London, UK).
Bosiers said that a hybrid suite with a flat panel fixed lab compared to a traditional suite brings higher quality to both percutaneous interventions and surgery. “In a fixed hybrid suite, the positioning of the table presents no disturbance from the C-arm. The offset arm allows flexible patient access during endovascular procedures and groin coverage.” Bosiers also noted that in fixed hybrid rooms the rotational imaging over 200°, the imaging acquisition time in 5, 10 or 20 seconds, the provision of 30 images per second and 3D reconstruction in 20 seconds allow perfect imaging.
“In fixed hybrid rooms the rotational imaging (GE Healthcare) facilitates intra-operative selection of branched and fenestrated stent grafts. It also allows both vascular imaging (vessel lumen and plaque) and visualisation of soft tissues,” Bosiers commented.
In terms of the operation room environment, Bosiers said, “A floor mounted system keeps the ceiling clear, which permits no interference with monitor access for any approach.” It is easy to clean and it does not have interference with laminar air flow or passing over the sterile field, he added.
Stéphan Haulon, chief of Vascular Surgery Hôpital Cardiologique – CHRU, Lille, France, favoured the use of mobile hybrid operating rooms. Haulon presented the OEC 9900 Elite MD (GE Healthcare) as an example of a mobile operating room which can be acquired at a lower cost compared to fixed hybrid operating rooms. The OEC 9900 Elite MD raises the mobile C-arm standard with a motorised C-arm. “It allows left and right patient access providing complete control of lateral and orbital C-arm movements for patient safety,” Haulon commented. “Everything can be performed with a table side control panel. I can control the whole set up myself. I can decide exactly the angulation that I need and I can see exactly the level in which I am with the floating table.” The control panel also contains diverse and easily adjustable dose settings which facilitate mask selection for fluoro roadmap, he said. “I think the motorisation is the key to success on performing complex endovascular aortic repairs,” Haulon stated. “In combination with the motorised system, the floating table helps you to shrink the overall operative time in between cases, I do not need to change table because I can perform all my open surgery and all my endovascular surgery on the same table…Now, from a regular EVAR it takes between 45 minutes to one hour, before it used to take almost one hour and a half,” he aded.
“The OEC 9900 Elite MD has a specific cooling system. I never have to stop because of over heating, even in complex procedures. It is a very safe and fast system, and it is very convenient for all the staff in the operating room,” Haulon concluded.