Hybrid Operation Theatre 

OBG-Speculum:    2024                       ISSN no.

Vol -2, Issue -1  

Any operating room with multidisciplinary arrangements or built-in imaging facilities like x-ray, fluoroscopy, C-arm etc can work as Hybrid OT. Most commonly being in use in cardiology and oncology, urology, setups.

Advantages:

·                Although it requires more OT space but less than the 2 OT rooms and allows the imaging facility then and there, per-operatively if required without shifting the patient.

·                It saves time and supports the surgical team.

·                Huge financial benefit to the hospital facility as well as the patient party.

·                Improves staff efficiency.

·                Multi-departmental experts can collaborate and share their knowledge for the best outcome

·                Patient safety from immediate or intraoperative movement is taken care of.

·                Reduced chances of infections as all fixed instruments in OT are timely sterilized.

There are some drawbacks too – bigger space required to adjust imaging equipment, high cost compared to simple small one-table OT, prolonged anesthesia etc.

Every new idea gets the critical remarks so it is there with Hybrid theatre as “Nicety or Necessity?” The answer is that it is necessary for particular surgeries where multidisciplinary collaboration is necessary and requires imaging or intervention radiology or chemotherapeutic equipment. Exp: advanced ovarian debulking requiring intraperitoneal chemotherapy postoperatively either hyperthermic or normothermic (HIPEC /NIPEC). So, Hybrid operation suit is a must for complex hybrid procedures as of gynecological oncology and should not be used for the routine basic surgical procedures where it will face the objection of Nicety.

Multitherapeutic or diagnostic equipment and improved collaboration of healthcare specialists sharing knowledge in one set-up are the advantages resulting in better and safer patient outcomes.

Setting up a Hybrid Operating Room is a challenging task keeping in mind the patient flow, space for movement and workflow, equipment integration, radiation safety etc. suggested size for it is 600 to 1000 square feet. In addition to the modular OTs these hybrid theatres require, advanced imaging systems and their control rooms by the side, multiple monitors, ultrasound, fluoroscopy unit, and C-arms for neurosurgery and orthopedic cases.

References:

Jin H, Liu J. Application of the Hybrid Operating Room in Surgery: A Systematic Review. J Invest Surg. 2022 Feb;35(2):378-389. doi: 10.1080/08941939.2020.1838004. Epub 2020 Nov 4. PMID: 33146589

Clark M, Horton J; Authors. Hybrid Operating Room Suites: CADTH Horizon Scan [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2023 June