Francois Nolte, Hybrid Rooms for Interventional Radiology Answers for life.
Hybrid Rooms for Interventional Radiology 1. Trends in Angiography 2. Rise of the hybrid operating room 3. Key Deployment Considerations 4. What does the future hold Page 2
Different challenges Blurring needs Hospital s Administrator Interventional Radiologist Interventional Cardiologist Surgeon Cancer Cardiovascular Diseases Renal Denervation Stroke Page 3
Stroke treatment in hybrid operating rooms Interventional Radiologist Interventional Cardiologist Neurologist Neuro Surgeon Courtesy: Dr. Mawad, St. Lukes Episcopal Hospital Houston, USA Page 4
How to optimize clinical outcome? Interventional Radiologist Interventional Cardiologist Andrew Holden Auckland University * Neurologist Endovascular Specialist Neuro Surgeon I have always thought that turf wars are more about physician s egos than optimum patient outcomes.. Patient outcomes are optimized if a team approach is used The physician with the training and skills to best do the job, irrespective of their background should do the procedure.. *source: Vascular News 02.2014 Page 5
Economic pressure Page 6
High utilization with multidisciplinary use Page 7
Our product portfolio for many clinical specialities Vascular Surgeon Neuro Surgeon Urologist Trauma Surgeon Surgery Cardiac Surgeon Thoratic Surgeon Orthopedic Surgeon General Surgeon Interventional Radiologist AX Interventional Cardiologist Neuro Radiologist Electrophysiologist Pediatric Radiologist Radiology Cardiology Pediatric Cardiologist Page 8
Treatment options for aortic valve stenosis Open heart surgery Transcatheter Aortic Valve Implantation ( TAVI ) Transapical approach mith Edwards Sapien Valve Page 9
Clinical Trends in Vascular Surgery Open surgery Endovascular Aortic Repair ( EVAR ) Evolution of EVAR in the USA * USA Open Operation EVAR Procedure 2001 31,965 11,028 2006 2010 15,665 28,937 50,220 454 % increase in EVAR procedures in 9 years Source: Grafic.stanford.edu * Veith Symposium 2013, New York Source Gloucestershire Vascular Group www.gvg.org.uk Page 10
Navigated spine surgery Page 11
Intra procedural 3D Imaging help to increase clinical outcome Endoleak visualization Laser Guided Endoleak Treatment Angiography Lukla Biasi Journal of Vascular Surgery, Volume 49, Issue 2, Pages 288-295, 2009 DynaCT Neal Cayne, MD, New York University, Langone Medical Center LINC Congress 2013, Leipzig Page 12
Hybrid Rooms for Interventional Radiology 1. Trends in Angiography 2. Rise of the hybrid operating room 3. Key Deployment Considerations 4. What does the future hold Page 13
The Hybrid OR Story Page 14
Siemens has a vast experience in building hybrid operating rooms 600 Hybrid Operation rooms with Artis Imaging systems Page 15
Hybrid Operating Rooms Advantages of a Hybrid Room: Sterile Environment for conversions for hybrid procedures Appropriate OR lights Logistics for OR Multi Discipline Utilization Page 16
Artis zeego Page 17
Artis zeego Especially designed for Operating Rooms Page 19
Hybrid Rooms for Interventional Radiology 1. Trends in Angiography 2. Rise of the hybrid operating room 3. Key Deployment Considerations 4. What does the future hold Page 20
Room Design 1st anesthesia boom Monitor ample on DCS Artis OR table 2nd anesthesia boom 2nd monitor ample on DCS Laminar air flow field OR lamps Artis zeego Page 21
Stakeholders Page 22
Hygiene conditions Anesthesia and a sterile Environment changed Surgery Page 23
Hygiene and laminar air flow No interference with the laminar air flow or the room ventilation Fewer potentially bacteria-harbouring dust particles falling down Page 24
Hybrid Rooms for Interventional Radiology 1. Trends in Angiography 2. Rise of the hybrid operating room 3. Key Deployment Considerations 4. What does the future hold Page 25
Bypass Surgery Page 26
Robotic supported bypass surgery reduce recovery time Professor Johannes Bonatti, University of Maryland, Baltimore / CCF Abu Dabi First Artis zeego in combination with Da Vinci Robot Page 27
Robotic supported bypass surgery reduce recovery time 3 weeks post OP Page 28
New disciplines Neurosurgery and orthopedics Indications and OR techniques Stereotactic procedures Aneurysm treatment Potential new application: Interventional treatment of stroke patients Hematoma surgery AV fistula treatment Spine surgery Page 29
New disciplines Endobronchial procedures and thoracic surgery Focus: Lung cancer Small and peripheral lung nodules are hard to biopsy and excise during VATS Interventional imaging in 2D and 3D can support both biopsies and VATS Courtesy Klinikum Coburg Page 30
New disciplines Trauma surgery OR with first-line diagnostic capabilities Immediate interventional treatment in the trauma unit Courtesy Karolinska Hospital Sweden Page 31
Fusion with pre-op MR Intra-op Image Pre-op Data DynaCT MR mbi@dkfz Fusion Page 32
Navigation with ipilot: 3D information from MR on live fluoroscopy Live Fluoroscopy Page 33
syngo DynaCT fusion with other image modalities Ultrasound fusion with Siemens S3000 CT, MR or PET CT Fusion 3D/3D Fusion and overlay in live fluoroscopy possible Verification of the surgical plan Registration of different modalities for best treatment strategy Precise guidance of surgical instruments Page 34 2013-XX-XX Courtesy of IHU Straßburg
syngo DynaCT in urology 3D-Fusion: Fusion of preoperative CT, MRI, PET CT, Ultrasound Page 35 2013-XX-XX
syngo DynaCT and endoscope fusion based on marker tracking Courtesy Teber, Heidelberg Page 36 2013-XX-XX
Angiography & Interventional X-Ray Systems. Answers for life. Francois Nolte Vice President Product Management E-mail: francois.nolte@siemens.com On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this presentation are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and are subject to change without prior notice. Page 37