Imaging, Surgical Companies Partner to Create Ideal Hybrid Cath Lab/ORs

For more than a decade, Dr. Barry T. Katzen, medical director of Baptist Cardiac and Vascular Institute (BCVI) in Miami, FL, has pioneered the integration of surgical and interventional procedures into a hybrid cath lab/OR. “The specialties of interventional radiology and vascular surgery bring more to each other when we work together,” Dr. Katzen said. “Procedures that help drive this relationship include aneurysms of the thoracic aorta and abdominal aorta. Having an environment where we can use a surgical option allows us to think out of the box for individualized patient solutions.” BCVI has eight angiography suites, and Room Two was the first hybrid suite. It worked well for traditional cath procedures, but Dr. Katzen found it was not optimally designed to accommodate his surgical colleagues. “Over time we made small modifications, trying to provide better lighting and trying to assure better access for the surgeons, but success was minimal,” he said. Based on a well-coordinated plan from Philips and Skytron, Room Two underwent a significant upgrade to enhance hybrid functionality. Improvements included: Allura Xper FD20 release three, including XperGuide, Xper table and enhanced 2D road mapping, focusable LED surgical lighting on overhead booms, anesthesia boom, and a second flat screen monitor for opposite side of table viewing. “What we’ve tried to do is create an environment that is more comfortable for our surgical colleagues and more comfortable for our anesthesia colleagues, while at the same time taking a lot of clutter off the floor,” Dr. Katzen said. Lighting and anesthesia booms from Skytron aid clinicians procedurally and helped clear the room, opening space for easy patient access. “Frequently in the room there’s a vascular surgeon, an interventional radiologist and then our team of techs and nurses,” said Dr. James F. Benenati, medical director of the peripheral vascular laboratory. “Often there’s an OR team there too. One of the great advantages of the new room design is it’s so spacious that we can all operate and function very effectively without being in each others way.” A multipurpose flat-screen monitor hanging from a ceiling boom can be positioned to allow clinicians working on the opposite side of the table to see what’s going on fluoroscopically. When that’s not required, the monitor is made available to other allied health personnel to chart and track ongoing procedures. “From a physician’s standpoint,” said Dr. Benenati, “the ergonomics of having that additional monitor in the room is great because you’re not put in an unnatural position with your head and neck straining to look at things.” With the Philips Allura Xper FD20, Dr. Katzen and his team can combine 3D-RA high-resolution vessel information with XperCT soft tissue information to aid in complex interventions. XperCT provides CT-like soft tissue imaging capabilities, mitigating the need to transport the patient. The FD20 also offers live 3D imaging, XperGuide, which aids percutaneous needle guidance. In two and a half weeks, Philips and Skytron completed the upgrade. The new room reflected the input of interventional radiologists, surgeons and anesthesiologists. “We do a lot of very sophisticated and challenging cases and certainly image optimization and system ease of use plays a critical role in allowing us to take on these cases,” Dr. Benenati said.