Hybrid operating rooms stand out as a groundbreaking step in the field of surgery. By combining traditional surgical methods with modern technology, they add an innovative dimension to healthcare services. These special operating rooms are used effectively for many disease groups such as brain, spinal cord and spine surgery and trauma surgery. Brain and Nerve Surgery Specialist Prof. Dr. Serdar Kahraman at Liv Hospital shared information on this topic.
O-ARM CT (0-ARM TOMOGRAPHY)
“Computed tomography can be taken during surgery with the mobile tomography device, which is a new generation imaging system. With this technology, 2- or 3-dimensional imaging can be performed at the time of surgery in both brain and spine-spinal surgery. Moreover, in three dimensions at a 360-degree angle, in as little as 13 seconds. The system also has a robotic positioning feature. In this way, the device can be approached to the patient table very quickly in the operating room and a tomography can be taken. Since it takes images in one go, images with the same image quality can be viewed throughout the surgery with one-third less radiation than other standard tomography devices.”
Most used areas
-In age-related spinal deformities
-Compressions in the spinal canal
-In spine tumors
-Spine curvatures in childhood and adolescence
-In some developmental diseases of the spine
-Screwing (platinum placement) in fractures and dislocations due to trauma
“While the success rate of spinal screwing surgeries performed with O-Arm technology, which can take 3-dimensional tomography images, increases, the margin of error also becomes zero. In addition, the chance of surgery success can be further increased by using the neuronavigation system, which works in harmony with the O-Arm CT device and can show all targets with high precision, at the same time. With a precision of 1-2 mm, the risk of injury to the spinal cord and nerve roots is almost eliminated and a safer surgery is performed. Thanks to the O-Arm CT system, tomography is performed under sterile conditions at the last stage of the surgery, minimizing undesirable situations that require the patient to undergo re-operation. The patient stands up in a short time and is discharged quickly.”
Advantages of spinal screw surgery performed with the O-Arm device:
-It provides critical information to the surgeon at every stage, reducing the risk of repeat surgery.
-The patient receives less radiation.
-With the smaller surgical incision, it provides the patient with a faster recovery and reduces bleeding.
-The system minimizes the major risks of complex surgeries.
-It reduces the risk of infection. The risk of screw-related paralysis is reduced to the lowest level.
NEURO-NAVIGATION SYSTEM
“It calculates the coordinates of a target to be visited in brain or spinal cord surgery with a system similar to GPS technology and allows the surgeon to see 3-dimensional scanned images. With “neuronavigation”, the targeted lesion in neurosurgery is approached with a high degree of accuracy (precision less than 1 mm). This minimizes the damage that may occur to healthy tissue. Before the surgery, the patient’s MRI and/or CT scan is taken and transferred to the navigation device. Thus, surgery is planned by seeing various risk areas in the patient’s brain and spine with real-time navigation.
In all cases of small and deep-seated tumors and similar cases, stereotaxic biopsy can be performed using only a small entry hole. In other words, a thin needle is directly reached to that area millimetrically and a tissue sample is taken. And of course, as a result of the pathological examination of this tissue sample, it is determined which treatment method the patient will be treated with.”
Advantages
-It moves flawlessly over the delicate anatomy and stays away from critical structures.
-The surgery is performed within more minimally invasive limits (surgery time is shortened with the small surgical incision)
-It provides safer surgery without disturbing the patient’s healthy anatomy.
NEW GENERATION FLUORESCENT FILTER MICROSCOPE
“With new generation microscopes and special light filters, tumor tissue stained with fluorescence, for example, can be easily distinguished from normal nerve tissue. Therefore, thanks to the special operating microscope combined with neuronavigation, maximum tumor removal is achieved with a smaller incision and with the least error. Apart from tumor surgeries, this system is also used in surgeries of cerebrovascular diseases.
For example, thanks to a special substance given intravenously to the patient during surgery, the filter of the microscope can be adjusted and the vessels of the brain can be seen, that is, cerebral vascular angiography can be performed. In this way, the vascular network of the brain is monitored before the surgery is completed. This increases the chance of treating cerebrovascular disorders more safely with surgical methods.”
INTRAOPERATIVE NEUROMONITORIZATION
“In order to minimize the damage (risk of paralysis) that may develop in the nerves due to brain tumor and spine surgeries, it is a system that provides continuous monitoring of the brain, spinal cord, nerve roots and reflex pathways on the monitor by giving electrical stimulation through electrodes placed on the patient’s scalp and muscles during the surgery. The system warns the surgeon if there is a change in the values monitored by the neurologist throughout the surgery. In this way, the patient is prevented from developing irreversible damage (such as paralysis) and a decrease in the quality of life is prevented. The patient can return to home and work life in a short time.”
What is a hybrid operating room?
“Hybrid operating room is a concept used for new concept operating room rooms where advanced medical imaging systems and medical devices can be used together at the same time… Hybrid operating rooms provide less trauma, smaller incisions, shorter operations, less blood for both the patient and the doctor. It means very important advantages such as loss of life, fewer complications, less hospitalization and less cost.”
