The operating rooms of surgical infrastructure represent the heart of an hospital. Among the hospital environments, they are those that in recent years have seen a technological revolution capable of introducing a strong change in the paradigms of care, making possible increasingly minimally invasive, safe and precise interventions that are now available to patients. From initially isolated environments, modern operating theaters are now multimedia environments capable of communicating with the outside world and accessing the hospital information fabric, to ensure that the operating team has access to patient information at all times.
Technologies that allow surgeons to see "through" the patient, to plan interventions in a timely manner and check their progress at any time, to magnify the differences in the tissues and visualize the details. The technological project of four new operating rooms was guided by a single paradigm: integrating state-of-the-art technological equipment in a single system that sees the patient at the exact center of every gesture.
In terms of minimally invasive laparoscopic surgery, the surgical possibilities are enhanced by an equipment that undoubtedly represents a perfect synthesis of the state of the art available today.
All operating rooms are in fact equipped with systems capable of guaranteeing, at the same time, very high definition vision (4K vision), three-dimensional vision (3D) and intraoperative angiographic fluorescence vision.
Intraoperative angiography systems, in particular, allow the surgeon, through the injection of a special contrast medium, to see in real time the perfusion of the tissues to better preserve the blood vessels or accurately visualize the necessary resection margins. To further support the surgeon, the department is equipped with intraoperative ultrasound systems and portable digital radiology systems.
The operating table systems are all "transferable shelves", the patient is welcomed into the operating compartment by a surgical plan configured on his specific surgical needs that will accompany him in all the phases of his stay in the operating sector, from the anesthetic induction phases, intervention, until his awakening in a dedicated room, avoiding unnecessary transfers.
Despite the impressive equipment, however, the operating rooms are not only the most technologically advanced one can imagine today, but are the result of an integration project born from the desire to immerse technology in a system capable of harmonizing them, putting the patient is at the center of every gesture and allowing surgeons to access every function and information available in a simple, accurate, intuitive and rapid way. All technologies, for example, are installed on hanging systems to allow maximum ergonomics in any surgical situation, no cables, no bulk, no positioning disturbs the surgical attention ensuring the maximum possible ergonomics.
The walls of the operating rooms house 65' displays, reporting workstations and systems capable of displaying the patient's diagnostic tests. The surgeon sees the necessary information and images at all times, without ever taking his eyes off the patient.
A multimedia management system is able to simultaneously ensure the distribution of images on the available display systems, the recording of the most significant contributions and the ability to communicate with the outside in a bidirectional way.
Through the integration of special high-definition cameras in the operating lighting systems and in the walls, the rooms are able to transmit in real time and anywhere in the world with the simple press of a button.
Live Surgery events thus become a simple possibility that makes operating theaters a permanently active didactic center.
The project of a new endoscopic Hybrid Operating Room completes the technological set-up phase of the Center for Diseases of the Digestive System (CEMAD), at the Agostino Gemelli I.R.C.C.S. University Hospital Foundation started in 2016, which will lead the center to be able to provide innovative and highly complex diagnostic and treatment services.
The hybrid endoscopy operating room is of particular importance for a digestive endoscopy center: the OR provides for the integration of a Computerized Tomography system with a multiaxial angiography system with a latest generation robotic arm. The radiological equipment is placed in an operating room specifically designed to allow a multidisciplinary approach, including:
In this way it is possible to obtain a 3D reconstruction of the patient's anatomy in real time and use it to guide the radio-guided minimally invasive surgical action through a multiaxial angiograph.
The project of the CEMAD Hybrid Room was created with the aim of guaranteeing the possibility of performing the most advanced surgical operative techniques on the hepatobiliary pancreatic district, with combined approaches.
This installation represents a unique installation of its kind and, consequently, the design effort to obtain an optimal technological arrangement and integration was significant.
By way of example, the main design criteria that have been used as guidelines for the realization are reported below.
The design of the new hybrid operating room has paid particular attention to the arrangement of the technologies present in order to ensure the maximum possible versatility: the arrangement of the CT in axis with the operating table and the positioning of the angiograph on the left side of the patient, both on the head side, represent the best compromise to allow the joint use of the technologies in the actual expected operating conditions, allowing the endoscopist to use the radiological systems with instruments in the working position.
A latest generation robotic multiaxial angiograph with technical characteristics suitable for the intended use was positioned inside the hybrid operating room.
The Artsi Pheno multiaxial angiography system is a unique system of its kind as it is equipped with a C-arm combined with a robotic system that allows the system to be positioned on the operating field in an optimal manner in relation to the position of the patient and the surgeons.
Diagnostic investigations and therapeutic procedures in all parts of the body are faster and more precise, the vision is better and the "dose" of radiation that is emitted is reduced to a minimum. Due to its peculiar characteristics, this type of technology is used in minimally invasive surgery, interventional radiology and interventional radiological cardiology.
In the room there is also a Computerized Axial Tomograph sliding Gantry with 128 slices.
The SOMATOM Definition Edge TAC with Sliding Gantry is an innovative 128-layer, rail-mounted CT scan featuring a fully integrated detector and TrueSignal technology that minimizes electronic noise for optimal low-dose diagnostic results. The 78 cm wide tunnel, the scanning range of 200 cm and the generator power of 80 kW, allow excellent adaptability to different anatomical types.
Noteworthy are the software equipment and the radiogenic dose reduction function.
Central to the implementation of the project, the multimedia integration project was developed in compliance with the technical specifications.
The functions are:
Also included were integrated audio systems and environmental camera.