Hybrid Rooms
THE NEW GENERATION OF OPERATING ROOMS

HPA Magazine 6

The hybrid operating room of the Hospital de Alvor was officially inaugurated on 13 May, another testament to the technological leadership and innovation that has always been part of the history of the HPA. 
Hybrid operating rooms are now a worldwide trend due to the vast number of proven benefits, as they allow for the use of the same space for surgical and nonsurgical interventions, using high definition equipment. These images are reproduced with advanced software systems, which produce a 3-dimensional reconstruction of the body structures, allowing it to be used in real time. In the specific case of the hybrid room at the Alvor Hospital, it is prepared for interventions in the specialties of cardiology, vascular surgery and neurosurgery.

The evolution of medicine in the fields of diagnostics and treatment is due in part to the simultaneous development of technology, which together have given rise to an increase in the safety and comfort of the patients, while guaranteeing the most satisfactory conditions for the professionals, so that everyone benefits from the best and most comprehensive results.
One example was the advent of hybrid rooms, which first emerged in some of the most sophisticated and technically developed North American and European hospitals. Nowadays, hybrid ORs are a worldwide tendency due to the proven benefits, as they allow for the use of the same space for both surgical and nonsurgical procedures, using high definition equipment. These images are reproduced with advanced software systems, which produce a 3-dimensional reconstruction of the body structures, allowing it to be used in real time.
All of these technical necessities require that the spaces conform to a design and a structure that allow the exams to be used before, during and after the interventions, providing greater safety and precision in complex procedures.
As such, minimally invasive procedures can be performed in the same space, monitored permanently and efficiently through catheters, with a considerable decrease in trauma and risk for the patients.
One good example is heart valve implants. Until recently, this procedure was only possible with open-heart surgery. Today, with hybrid ORs, all that is necessary is a small incision in the groin area or in the apex of the heart, thanks to the visualisation of the procedure through high-resolution images. This system gives the team – anaesthesiologist, interventional cardiologist, cardiovascular surgeon, nurses and technicians – the precise, simultaneous 3D visualisation of the entire anatomy involved.

The main benefit of hybrid operating rooms is the possibility of making diagnostic and interventional gestures during the surgical procedure. The patient’s safety is therefore inherent: the minimally invasive techniques offer less surgical trauma, a reduction in recuperation time, lower transfusion rate and better aesthetic results, when compared to conventional surgery.
In the case of interventional cardiology, vascular or endovascular surgery, some of the possible and more common hybrid procedures are myocardial revascularization surgery associated with percutaneous transluminal coronary angioplasty or associated with carotid angioplasty; percutaneous valve implants or a hybrid approach to correcting aneurisms and arteriovenous malformations, among others.
In the field of neurosurgery, there are various procedures that benefit from the hybrid operating rooms. In Alvor, it has already been possible to perform minimally invasive osteosynthesis with fixation on a complex spinal column fracture, and a kyphoplasty. This is a percutaneous technique for treating vertebral compression fractures in osteoporotic patients. Orthopaedic cement is injected at low pressure into the vertebra by means of a balloon, which causes expansion, i.e. reconstituting the height of the collapsed vertebra, and therefore correcting the deformity caused by the fracture.