Imaging meets Surgery - The Hybrid OR

Introduction: The merger of interventional and open surgical procedures leads to novel approaches in various clinical fields. Imaging becomes a critical tool and success factor because it allows for visualization of the targeted anatomical structures and leads the way for the clinician. Moreover high-end imaging (Angiography, CT, MRI) available in the operating room allows for assessment of treatment results immediately at the point of care which helps to avoid complications and the need for revision surgery. Methods: Operating rooms in various clinical fields are equipped with high-end imaging systems. The most prominent example is the angiography system in cardiovascular operating theatres. Requirements for imaging and other medical equipment vary among clinical specialties. Infrastructure and building technology are also important topics for planning and implementation. Workflow and hygienic requirements should not be forgotten. Thus building a hybrid OR is a complex technical challenge. Based on the experience of more than 400 installed angiography systems in Operating Rooms in more than 30 countries worldwide we have put together lessons learned and recommendations for planning and implementation. Results: Planning needs to consider all aspects and components from building technology to medical equipment. Early planning and room design with all stakeholders and balancing clinical requirements and technical feasibility is critical for success. Hygienic requirements vary significantly and therefore should be discussed and considered according to local regulations. Space in the OR is of essence. Irrespective of the angiography system a minimum of 70 m(2) is recommended to accommodate the complex workflows and equipment needs. Conclusion A hybrid operating room is a highly specialised workplace with very customer specific requirements. The boundary conditions and clinical requirements define the best design and concept for the room. Comprehensive application training on how to use the room and the equipment are mandatory to enable the proper use of the new surgical workspace - hybrid OR.