ABSTRACT
Lung cancer ranks the first cancer-related morbidity and mortality in China. With the development and penetration of imaging technology, increasing small pulmonary peripheral Nodules (SPPNs) have been detected. However, precise location and diagnosis of SPPNs is still a tough problem for clinical diagnosis and treatment in department of thoracic surgery. With the development of electromagnetic navigation bronchoscopy (ENB), it provides a novel minimally invasive method for the diagnosis and treatment of SPPNs. In this review, we summarized the application and progress of ENB in preoperative positioning, diagnosis, and local treatment, then, discussed the clinical application of ENB in the hybrid operating room. .
Subject(s)
Humans , Bronchoscopy/methods , Electromagnetic Phenomena , Lung Neoplasms/surgery , Multiple Pulmonary Nodules/diagnosis , Thoracic SurgeryABSTRACT
Objective To: explore the clinical value of one-stop procedure in DSA hybrid operating room for treatment of ruptured intracranial complex aneurysms combined with cerebral hematomas. Methods: Eleven patients within 72 h after onset of ruptured intracranial complex aneurysms combined with cerebral hematomas without cerebral hernia underwent one-stop procedure in DSA hybrid operating room. Intraoperative DSA was used to evaluate whether the aneurysm involved the parent artery. The aneurysms were treated with intracranial aneurysm isolation combined with extra-intracranial bypass under the guidance of DSA or temporary balloon occlusion assisted shape clipping. And the hematomas were removal appropriately. Intraoperative situation of hybrid surgery was monitored in real time. Intraoperative and postoperative complications were recorded. The patients were followed up after discharge. CTA examinations were performed 6 months after operation. Glasgow outcome score (GOS) was used to evaluate the efficacy when patients were discharged and the last follow-up. When the scores were equal or greater than 4, the discharge was considered as effective treatment. Results: Superficial tempora1 artery (STA)-middle cerebral artery (MCA) bypass were performed in 5 patients smoothly. Intraoperative DSA revealed that the bridge vessel was unobstructed, and the aneurysms were isolated in one stage. Six patients were treated with shape clipping. Mistakenly clipping of perforator vessels occurred in 3 patients, and incomplete clipping occurred in 1 patient. The clamping effect was satisfactory after adjusting the positions of aneurysm clips. There were 2 cases of focal infarction and 1 case of epilepsy after operation. The proportion of patients responded well to treatment was both 81.82% (9/11) when discharged and the last follow-up, respectively. No recurrence, stenosis of anastomotic nor parental artery was detected among 11 patients 6 month after operation. Conclusion: Patients with complex aneurysms associated with intracranial hematomas impossible treated with single surgical clipping or endovascular intervention can be cured with one-stop procedure in DSA hybrid operating room with relatively satisfied results.
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Free‑floating right heart thrombi are uncommon and need emergency treatment in view of their tendency to dislodge and cause pulmonary embolism. We report a successful surgical management of a patient who had large mobile right atrial thrombus, bilateral pulmonary thrombi, coronary artery disease, and postmyocardial infarction ventricular septal rupture (VSR). The patient underwent coronary angiography, inferior vena cava filter placement, removal of thrombi from the right atrium and pulmonary arteries, repair of VSR, and coronary artery bypass graft surgery in a hybrid operating room.
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Today's operation environment integrated complex imaging and image integration of sterile surgical guide equipment and advanced technology, the highly advanced equipment, technology is a highly integrated, high degree of integration, completely changed the traditional surgery, arises at the historic moment is complex suitable for different types of operation of the operating room. This paper summarizes some compound in the operating room development course, according to the clinical demand constantly appear different type composite configuration and composite operating room equipment, for the future development of composite operating room was prospected.
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PURPOSE: Operating room management is the serious and complex task for hospital managers and the common approach is to develop relevant standard operational procedures. From patient and staff safety perspective, operating room management should be well-studied and hospital should identify and address any potential risks. Simultaneous usage of different imaging and less-invasive treatment technologies demands strong management control. MATERIALS AND METHODS: We have formed the multidisciplinary expert panel (surgeons, anesthesiologists, radiologists, healthcare managers etc.) for hybrid theater management standard operational procedure development. On the first stage the general concept of hybrid room design and patient routing was developed. The second stage included the technical details discussion. For patient safety improvement we modified the Surgical Safety Check-list in accordance with potential MRI-related safety challenges and concerns. RESULTS: WHO Surgical Safety Checklist is a simple and easy-to use tool which includes three blocks of question (grouped by the surgery process). We have developed two additional blocks of questions for the intraoperative magnetic resonance investigation. It is very important to have a special detailed routing with a strong control of ferromagnetic devices and anesthesiology care. CONCLUSION: High-energy MRI (1.5-3.0T) is characterized by potential influence on patient and staff safety in case of hybrid surgery. It is obvious to have a strong managerial control of ferromagnetic devices and anesthesiology care. Surgical Safety Checklist is the validated tool for improving patient safety. Modification and customization of this check-list potentially provides the opportunity for surgery processes improving.
Subject(s)
Humans , Anesthesiology , Checklist , Delivery of Health Care , Magnetic Resonance Imaging , Magnets , Operating Rooms , Patient Safety , Safety ManagementABSTRACT
Hybrid operating room is used and spread in China with the development of medical equipment and the integration of medical technology. As a new equipment and advanced technology, it faced some questions and challenges on its construction and development. We analyzed the definition, classification, construction and use which combined the development history and clinical application, and proposed some suggestions on how to strengthen the development and construction of hybrid operating room.
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PURPOSE: Endovascular interventions have seen explosive growth over the last decade. One of the critical factors to perform safe and reliable endovascular procedures is the availability of a well-equipped endovascular suite. The aim of this study is to clarify the necessity and benefits of an endovascular suite through our initial experience. METHODS: We performed an overview of the basic equipment and the adjunctive hardware and software of an endovascular suite for performing open surgical exposures or/and endovascular procedures. We also conducted a review of the endovascular procedures that were performed for 2 months in a newly built endovascular suite. RESULTS: The endovascular suite should offer sterile conditions to provide the endovascular specialist a complete gamut of options to treat patients with complex vascular diseases. The number of vascular and endovascular treatments increased about two fold after the establishment of the endovascular suite. CONCLUSION: The establishment of a modern endovascular suite arranged in an ergonomically devised fashion is helpful to remain on the cutting edge of medical practice. A endovascular suite will undoubtedly enhance the ability of vascular surgeons to provide quality health care to the patients who have a variety of arterial and venous disorders.