Hybrid ORs and Imaging Techniques: Advances in Minimally Invasive Procedures

Hybrid operating rooms are constructed and equipped for both open and minimally invasive surgery, enabling vascular surgeons to perform highly complex procedures while potentially improving accuracy and efficiency. On Friday morning, experts will discuss these increasingly popular blended surgical theaters, the state-of-the-art imaging technologies they incorporate, and ways to reduce associated radiation exposure in “New Developments in Hybrid Operating Suites and Improvements in Imaging.”

“Endovascular techniques have transformed our practice for the better, but have raised new challenges. We’re treating more and more challenging anatomies by endovascular means, with the potential for exposure to higher doses of ionizing radiation for staff and patients, higher contrast volume dose for patients, and the chances of complications,” said moderator Dr. Frans L. Moll, a professor of vascular surgery and head of the department of surgery at University Medical Center Utrecht in the Netherlands.

Fortunately, technological and technical advances are helping lessen these safety concerns, Dr. Moll said. For example, clinicians are incorporating pre-acquired diagnostic imaging into image fusion techniques to support catheter navigation, and are starting to use x-ray equipment that is designed for the OR environment and that employs lower radiation dose protocols than standard machines. Studies show that these novel x-ray imaging technologies can significantly decrease radiation exposure of both patients and staff who work in hybrid ORs, without reductions in procedure or fluoroscopy time.

The session will be co-moderated by Dr. Daniel Clair, professor of surgery at Cleveland Clinic Lerner College of Medicine, Case Western University. Attendees will learn about the expanding role of advanced imaging in hybrid procedures, said Dr. Moll. Notably, three-dimensional imaging and image fusion techniques are enabling endovascular surgeons to “see what one could see in open surgery,” he added. “These advancements will give physicians more insight and confidence in the treatment of complex anatomy in a minimally invasive setting.”

At the beginning of the session, Dr. Neal Cayne, of NYU Langone Medical Center, New York City, and Dr. Alan Lumsden, of Houston Methodist, Houston, Texas, will discuss how fusion can reduce exposure to radiation and contrast, and how advances in fusion techniques can prevent registration errors that result from anatomical distortions caused by wires and sheaths. Dr. Thomas Carrell, of King’s College, London, will then describe a new automated three-dimensional fusion overlay system that works with both fixed and mobile digital fluoroscopes and re-registers in response to movement of the patient or OR table.

Despite rising demand for hybrid ORs, “questions remain about the need for these technologies in everyday practice,” said Dr. Clair. Experts also are debating the best use of interventional robotic technology and CT imaging during interventions, and the optimal use of these technologies for image registration. Nonetheless, advances in hybrid room imaging are cutting radiation exposure and operative time and improving outcomes, said Dr. Clair. “Over time, the use of these technologies will be invaluable to clinicians,” he added.

Next, Dr. Lieven Maene, of OLV Hospital Aalst, Belgium, will offer “tips and tricks” for optimizing the hybrid OR to reduce radiation dose and protect patient’s kidneys, followed by an update by Dr. Timothy Resch, of Skåne University Hospital in Malmö, Sweden, on how rotation angio-CT can improve endovascular procedures compared with standard digital subtraction angiography and pressure measurements.

To close the session, Dr. Stephan Haulon, of CHRU de Lille, France, will discuss new assets for hybrid suites, and Dr. Rodney White, of the UCLA School of Medicine and Harbor-UCLA Medican Center, Los Angeles, will recommend ways to train staff in hybrid ORs, particularly when using equipment during complex aortic procedures.

“Ongoing improvements in technology and methods should help us overcome the challenges” of increased radiation and contrast exposure, Dr. Moll said. He looks forward in the next decade to continued advances in ‘”clean technologies, as I call them – low-radiation or even radiation-free technologies to help us do our job in a safer way for patients and staff. And further progress in three-dimensional imaging will help us treat patients with challenging anatomies even better.”

Session 87: New Developments in Hybrid Operating Suites and Improvements in Imaging

Friday, 9:37 a.m. – 11:11 a.m.

Grand Ballroom West, 3rd Floor

Hybrid operating rooms are constructed and equipped for both open and minimally invasive surgery, enabling vascular surgeons to perform highly complex procedures while potentially improving accuracy and efficiency. On Friday morning, experts will discuss these increasingly popular blended surgical theaters, the state-of-the-art imaging technologies they incorporate, and ways to reduce associated radiation exposure in “New Developments in Hybrid Operating Suites and Improvements in Imaging.”

“Endovascular techniques have transformed our practice for the better, but have raised new challenges. We’re treating more and more challenging anatomies by endovascular means, with the potential for exposure to higher doses of ionizing radiation for staff and patients, higher contrast volume dose for patients, and the chances of complications,” said moderator Dr. Frans L. Moll, a professor of vascular surgery and head of the department of surgery at University Medical Center Utrecht in the Netherlands.

Fortunately, technological and technical advances are helping lessen these safety concerns, Dr. Moll said. For example, clinicians are incorporating pre-acquired diagnostic imaging into image fusion techniques to support catheter navigation, and are starting to use x-ray equipment that is designed for the OR environment and that employs lower radiation dose protocols than standard machines. Studies show that these novel x-ray imaging technologies can significantly decrease radiation exposure of both patients and staff who work in hybrid ORs, without reductions in procedure or fluoroscopy time.

The session will be co-moderated by Dr. Daniel Clair, professor of surgery at Cleveland Clinic Lerner College of Medicine, Case Western University. Attendees will learn about the expanding role of advanced imaging in hybrid procedures, said Dr. Moll. Notably, three-dimensional imaging and image fusion techniques are enabling endovascular surgeons to “see what one could see in open surgery,” he added. “These advancements will give physicians more insight and confidence in the treatment of complex anatomy in a minimally invasive setting.”

At the beginning of the session, Dr. Neal Cayne, of NYU Langone Medical Center, New York City, and Dr. Alan Lumsden, of Houston Methodist, Houston, Texas, will discuss how fusion can reduce exposure to radiation and contrast, and how advances in fusion techniques can prevent registration errors that result from anatomical distortions caused by wires and sheaths. Dr. Thomas Carrell, of King’s College, London, will then describe a new automated three-dimensional fusion overlay system that works with both fixed and mobile digital fluoroscopes and re-registers in response to movement of the patient or OR table.

Despite rising demand for hybrid ORs, “questions remain about the need for these technologies in everyday practice,” said Dr. Clair. Experts also are debating the best use of interventional robotic technology and CT imaging during interventions, and the optimal use of these technologies for image registration. Nonetheless, advances in hybrid room imaging are cutting radiation exposure and operative time and improving outcomes, said Dr. Clair. “Over time, the use of these technologies will be invaluable to clinicians,” he added.

Next, Dr. Lieven Maene, of OLV Hospital Aalst, Belgium, will offer “tips and tricks” for optimizing the hybrid OR to reduce radiation dose and protect patient’s kidneys, followed by an update by Dr. Timothy Resch, of Skåne University Hospital in Malmö, Sweden, on how rotation angio-CT can improve endovascular procedures compared with standard digital subtraction angiography and pressure measurements.

To close the session, Dr. Stephan Haulon, of CHRU de Lille, France, will discuss new assets for hybrid suites, and Dr. Rodney White, of the UCLA School of Medicine and Harbor-UCLA Medican Center, Los Angeles, will recommend ways to train staff in hybrid ORs, particularly when using equipment during complex aortic procedures.

“Ongoing improvements in technology and methods should help us overcome the challenges” of increased radiation and contrast exposure, Dr. Moll said. He looks forward in the next decade to continued advances in ‘”clean technologies, as I call them – low-radiation or even radiation-free technologies to help us do our job in a safer way for patients and staff. And further progress in three-dimensional imaging will help us treat patients with challenging anatomies even better.”

Session 87: New Developments in Hybrid Operating Suites and Improvements in Imaging

Friday, 9:37 a.m. – 11:11 a.m.

Grand Ballroom West, 3rd Floor

Hybrid operating rooms are constructed and equipped for both open and minimally invasive surgery, enabling vascular surgeons to perform highly complex procedures while potentially improving accuracy and efficiency. On Friday morning, experts will discuss these increasingly popular blended surgical theaters, the state-of-the-art imaging technologies they incorporate, and ways to reduce associated radiation exposure in “New Developments in Hybrid Operating Suites and Improvements in Imaging.”

“Endovascular techniques have transformed our practice for the better, but have raised new challenges. We’re treating more and more challenging anatomies by endovascular means, with the potential for exposure to higher doses of ionizing radiation for staff and patients, higher contrast volume dose for patients, and the chances of complications,” said moderator Dr. Frans L. Moll, a professor of vascular surgery and head of the department of surgery at University Medical Center Utrecht in the Netherlands.

Fortunately, technological and technical advances are helping lessen these safety concerns, Dr. Moll said. For example, clinicians are incorporating pre-acquired diagnostic imaging into image fusion techniques to support catheter navigation, and are starting to use x-ray equipment that is designed for the OR environment and that employs lower radiation dose protocols than standard machines. Studies show that these novel x-ray imaging technologies can significantly decrease radiation exposure of both patients and staff who work in hybrid ORs, without reductions in procedure or fluoroscopy time.

The session will be co-moderated by Dr. Daniel Clair, professor of surgery at Cleveland Clinic Lerner College of Medicine, Case Western University. Attendees will learn about the expanding role of advanced imaging in hybrid procedures, said Dr. Moll. Notably, three-dimensional imaging and image fusion techniques are enabling endovascular surgeons to “see what one could see in open surgery,” he added. “These advancements will give physicians more insight and confidence in the treatment of complex anatomy in a minimally invasive setting.”

At the beginning of the session, Dr. Neal Cayne, of NYU Langone Medical Center, New York City, and Dr. Alan Lumsden, of Houston Methodist, Houston, Texas, will discuss how fusion can reduce exposure to radiation and contrast, and how advances in fusion techniques can prevent registration errors that result from anatomical distortions caused by wires and sheaths. Dr. Thomas Carrell, of King’s College, London, will then describe a new automated three-dimensional fusion overlay system that works with both fixed and mobile digital fluoroscopes and re-registers in response to movement of the patient or OR table.

Despite rising demand for hybrid ORs, “questions remain about the need for these technologies in everyday practice,” said Dr. Clair. Experts also are debating the best use of interventional robotic technology and CT imaging during interventions, and the optimal use of these technologies for image registration. Nonetheless, advances in hybrid room imaging are cutting radiation exposure and operative time and improving outcomes, said Dr. Clair. “Over time, the use of these technologies will be invaluable to clinicians,” he added.

Next, Dr. Lieven Maene, of OLV Hospital Aalst, Belgium, will offer “tips and tricks” for optimizing the hybrid OR to reduce radiation dose and protect patient’s kidneys, followed by an update by Dr. Timothy Resch, of Skåne University Hospital in Malmö, Sweden, on how rotation angio-CT can improve endovascular procedures compared with standard digital subtraction angiography and pressure measurements.

To close the session, Dr. Stephan Haulon, of CHRU de Lille, France, will discuss new assets for hybrid suites, and Dr. Rodney White, of the UCLA School of Medicine and Harbor-UCLA Medican Center, Los Angeles, will recommend ways to train staff in hybrid ORs, particularly when using equipment during complex aortic procedures.

“Ongoing improvements in technology and methods should help us overcome the challenges” of increased radiation and contrast exposure, Dr. Moll said. He looks forward in the next decade to continued advances in ‘”clean technologies, as I call them – low-radiation or even radiation-free technologies to help us do our job in a safer way for patients and staff. And further progress in three-dimensional imaging will help us treat patients with challenging anatomies even better.”

Session 87: New Developments in Hybrid Operating Suites and Improvements in Imaging

Friday, 9:37 a.m. – 11:11 a.m.

Grand Ballroom West, 3rd Floor