A hybrid operating room for combined surgical and endovascular procedures for cerebrovascular diseases: a clinical experience at a single centre

Choi, Hyuk Jai; Lee, Su Hwan; Jeon, Hong-Jun; Cho, Byung-Moon; Yoon, Dae Young

doi:10.1080/02688697.2019.1617403

Cited by 20 publications

(12 citation statements)

References 31 publications

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“…On the other hand, the benefits of hybrid trauma management must be weighed against the high cost and human resource demand of these rooms and workflows [20]. Furthermore, the limited availability of hybrid rooms should be taken into consideration since hybrid rooms are used not only for trauma management, but for a wide range of procedures as well, such as treatment of neurovascular disease [8], which is mainly performed in elective surgery settings. Similarly, new approaches for aortic valve replacement utilize hybrid operating rooms in some medical centers and are also performed electively [10].…”

Section: Resultsmentioning

confidence: 99%

Hybrid Trauma Management: Is It the Way We Are Heading?

Paran¹,

Kessel²

2020

JEVTM

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Background: Hybrid trauma management, namely, the combination of open and endovascular techniques and/or the application of endovascular methods in the OR/ER is a quickly growing concept worldwide. However, its implications are not well established. We aimed to review the current data regarding hybrid trauma management in medical literature. Methods: A review of the medical literature published between 2000 and 2020 using PubMed and OVID Medline databases was performed in search for clinical studies regarding hybrid trauma treatments. Case reports were excluded from this review. The manuscripts were analyzed regarding the mechanism, location and type of injury, endovascular and surgical techniques utilized and outcomes. Results: Fourteen studies reporting hybrid trauma management of a total of 1049 patients met the inclusion criteria and were analyzed. Blunt trauma was the leading trauma mechanism (87.13%) and the most common procedure was transcatheter arterial embolization (TAE), performed in 29.74% of patients. The overall mortality was 15.16%. Regarding case control studies, 85.71% have shown hybrid trauma management to be associated with a shorter time from arrival to intervention, 42.86% reported lower rates of unfavorable outcome 28.57% reported reduced requirement for red blood cell transfusion as compared with conventional management. Conclusions: This review did not find strong evidence supporting hybrid trauma management as a standard care. However, accumulating data suggests that hybrid management may be associated with a shorter time from arrival to intervention, lower rates of unfavorable outcome and reduced requirement for red blood cell transfusion as compared with conventional management of trauma patients.

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Section: Resultsmentioning

confidence: 99%

Hybrid Trauma Management: Is It the Way We Are Heading?

Paran¹,

Kessel²

2020

JEVTM

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“…Hybrid surgery (microsurgical resection coupled with endovascular embolization) for bAVM has been proved to be safe and effective, with high rates of immediate, complete, and permanent bAVM obliteration (5,6,10,12,13,27). Routine intraoperative DSA after microsurgical resection can identify the AVM remnant directly for one-stop resection (12,27).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Monitoring Cerebral Blood Flow During the Treatment of Brain Arteriovenous Malformations in Hybrid Operating Room by Laser Speckle Contrast Imaging

et al. 2022

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BackgroundHemodynamic changes caused by hybrid surgery for brain arteriovenous malformations (bAVM) are usually related to long-term lesions from “blood stealing”. There are currently no viable low-cost, noninvasive procedures for assessing cerebral perfusion in the operating room. This study aims to investigate the use of intraoperative laser speckle contrast image (LSCI) software in AVM surgery.MethodsIn Zhongnan Hospital of Wuhan University, 14 patients who underwent surgery with LSCI were collected. To analyze the hemodynamic features of AVM and the influence on the peripheral cortex of AVM embolization and resection, we assessed the transit time between feeding arteries and drainage veins by intraoperative digital subtraction angiography (DSA). Meanwhile, LSCI was performed at pre-embolization, post-embolization, and after complete resection of bAVM.ResultsIn this study, the transit time of bAVM before and after embolization was compared, the transit time before embolization was significantly shorter than that after embolization (p < 0.05). We also got good visualization of relative CBF, in addition, to flow imaging in the cortical vasculature round bAVM with LSCI. The flux of post-surgery was significantly higher than pre-embolization (p < 0.01).ConclusionHemodynamic variable assessment plays an important role in the resection of AVM in the hybrid operative room and LSCI can be used to visualize and evaluate cortical cerebral blood flow to detect pathological hyperperfusion in real-time with a good spatial-temporal resolution in a sensitive and continuous, non-invasive mode.

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“…Hospitals worldwide are now exploring the hidden potential of hybrid suites, as they combine state-of-the-art imaging technology with the sterile environment required for surgical procedures. Therefore, there is an opportunity for integrative thinkers to improve the quality of care and optimize the cost-efficiency associated with these clinical facilities (Choi et al, 2019;Urbanowicz & Taylor, 2010). Furthermore, the HOR market is expected to grow at a compound annual growth rate (CAGR) of 12.5% and reach US$1.17 billion by 2022 (' Markets and Markets, 2017), driven by increased adoption of minimally invasive surgical procedures and ongoing technological advancements.…”

Section: The Patient Table In the Hormentioning

confidence: 99%

“…Therefore, improving current offerings would enable healthcare providers to perform more complex surgeries using minimally invasive techniques and also guarantee a safe and sterile environment in the hybrid suite (Choi et al, 2019; see also Vascular News, 2015). Nevertheless, meaningful product innovation is a challenge to manufacturers of medical equipment, as they must wisely balance their technological strengths and limitations with the changing needs of multiple clinical teams.…”

Section: Introductionmentioning

confidence: 99%

Organizing Value-based Product Innovation: How Medical Equipment Manufacturers Embrace Complexity in Hybrid Operating Rooms

Mendes

Rademakers

2021

Journal of Creating Value

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This article shares research findings from the healthcare equipment manufacturing industry on how product management teams can enhance their value-based innovation processes. Value-based healthcare (VBHC) has transformed healthcare systems worldwide by shifting their focus towards patient-centred value creation. The VBHC concept has also inspired medical equipment manufacturers that seek to enable healthcare providers to realize their VBHC ambitions. In this article, we focus on the development of hybrid solutions for operating rooms in the context of VBHC. Hybrid operating rooms (HORs) add real-time medical imaging to surgical and interventional treatment of patients. This combination is quite challenging to realize, not just in terms of technology but also organizationally. Adjusting technology to the requirements of multiple clinical stakeholders drives complexity to unprecedented heights. How can product strategists manage this multi-stakeholder complexity? Through in-depth case research, we found that adopting a clear VBHC vision is key for product management teams designing HOR innovations. A VBHC vision allows multiple teams to align and effectively collaborate with the goal of enhancing patient care. In addition, we found that integrating inside-out and outside-in perspectives on product innovation helps medical equipment manufacturers produce VBHC-compatible innovations and foster collaboration between clinicians working in multipurpose rooms such as HORs.

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A hybrid operating room for combined surgical and endovascular procedures for cerebrovascular diseases: a clinical experience at a single centre

Cited by 20 publications

References 31 publications

Hybrid Trauma Management: Is It the Way We Are Heading?

Hybrid Trauma Management: Is It the Way We Are Heading?

Intraoperative Monitoring Cerebral Blood Flow During the Treatment of Brain Arteriovenous Malformations in Hybrid Operating Room by Laser Speckle Contrast Imaging

Organizing Value-based Product Innovation: How Medical Equipment Manufacturers Embrace Complexity in Hybrid Operating Rooms

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