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Hybrid OR: the changing landscape calls for new approaches

by Lauren Dubinsky, Senior Reporter | February 25, 2015
Cardiology Medical Devices
From the January/February 2015 issue of HealthCare Business News magazine

If a surgeon is performing a very complicated minimally invasive procedure and open surgery is suddenly required, they must be able to move the gantry out of the way immediately. If the system is mobile it makes that process much easier.

GE also took note that for each type of procedure, the surgeon approaches the patient from a different angle — for a cardiac case, the surgeon would be on the left side of the patient, but in a vascular case the surgeon would be on the right side. A mobile system can be helpful in handling those different types of procedural approaches.

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Ever since the IGS 730 and 740 hit the market, GE has noticed that many of the smaller hospitals have taken an interest in the technology. “These hospitals would not be able to financially sustain having a high-end hybrid OR dedicated to just one department or one procedure,” says Rasenberg. “They would be looking for synergies between different departments to optimize the return on investment.”

Keeping track of dose
In 1992, the Center for Devices and Radiological Health and the FDA received reports of potential patient radiation injuries as a result of fluoroscopic X-ray exams. In early 1994, mandatory radiation dose requirements under the Safe Medical Devices Act of 1990 provided information that proved that the dose associated with the X-ray systems were causing harm to the patients.

Now, millions of fluoroscopically guided procedures are performed on an annual basis and many organizations including Accreditation for Cardiovascular Excellence are recommending and even requiring hospitals to monitor and record patient radiation dose. In response, many of the new fluoroscopy systems on the market have build-in radiation reporting and managing capabilities.

In March, Toshiba launched its Dose Tracking System (DTS) for its Infinix cardiovascular X-ray systems. It displays a real-time 3-D model of the patients with color-coded radiation dose so the physician can change the distribution throughout the procedure. Once the dose reaches the yellow zone at 1.5 Gy, the physician is alerted to move the X-ray beam. When the procedure is finished, the system generates a dose report, which lists the peak skin dose and displays a colorcoded 3-D patient model.

Toshiba announced enhancements to DTS in early November including new patient head models that allow the system to provide peak skin dose estimates for neurovascular procedures. It also features frontal and lateral bi-plane coverage, which is optimal for neurovascular and congenital cardiology cases.

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