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hybrid operating suite

L Fidalgo Domingos, E M San Norberto García, D Gutiérrez Castillo, C Flota Ruiz, I Estévez Fernández, C Vaquero Puerta
BACKGROUND: Endovascular procedures come with a potential risk of radiation hazards both to patients and to the vascular staff. Classically, most endovascular interventions took place in regular operating rooms using a fluoroscopy C-arm unit controlled by a third party. Hybrid operating rooms (HOR) provide an optimal surgical suit with all the qualities of a fixed C-arm device, while allowing the device to be controlled by the surgical team. The latest studies suggest that an operator-controlled system may reduce the radiation dose...
February 28, 2018: Annals of Vascular Surgery
Abraham Sonny, Brett J Wakefield, Shiva Sale, Stephanie Mick, Bruce L Wilkoff, Anand R Mehta
With increasing use of cardiovascular implantable electronic devices, the need for lead extractions has increased to an annual volume of more than 10,000 extractions worldwide. This article provides a focused clinical commentary on the perioperative management, identification, and treatment of life-threatening complications associated with lead extractions. In addition, a summary of indications, techniques, and lead extraction complications is provided. Although uncommon, lead extractions are associated with a consistent rate of major procedure-related complications and mortality...
January 10, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Nabeel A Riza, Mohsin A Mazhar
Demonstrated is the code division multiple access (CDMA)-mode coded access optical sensor (CAOS) smart camera suited for bright target scenarios. Deploying a silicon CMOS sensor and a silicon point detector within a digital micro-mirror device (DMD)-based spatially isolating hybrid camera design, this smart imager first engages the DMD starring mode with a controlled factor of 200 high optical attenuation of the scene irradiance to provide a classic unsaturated CMOS sensor-based image for target intelligence gathering...
December 11, 2017: Optics Express
Claire Thompson, Sarah Milton, Matt Egan, Karen Lock
BACKGROUND: Recognising the lack of research on daytime drinking practices in areas with managed night-time economies (NTEs), this qualitative study explores the phenomena in the London Borough of Islington; a rapidly gentrifying area with a highly regulated night-time economy (NTE). The objectives were to (i) Characterise the daytime drinking spaces of the local alcohol environment and (ii) Theorise the ways in which these spaces, and the practices and performativities within them, are situated within broader social and economic trends...
February 2018: International Journal on Drug Policy
Desarom Teso, Benjamin J Rogoway, Yolanda L Vea, Judson E Threlkeld, George R Dulabon, Riyad C Karmy-Jones
A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Erez Nossek, Avi Setton, David J Chalif
BACKGROUND: Mycotic aneurysms, although well recognized, are relatively rare intracranial vascular pathology. These aneurysms are typically located in distal cortical vessels. When these aneurysms are located in eloquent cerebral territories, they may become challenging to treat. Eloquent location may necessitate intraoperative angiographic evaluation to verify complete aneurysmal occlusion/obliteration and preservation of normal adjacent vasculture. Recently, ICG videoangiography has become a widely used intra-operative adjunct and is an important tool used to assess complete occlusion and vessel patency at the conclusion of clip reconstruction...
March 2018: Acta Neurochirurgica
Sven M J Rogge, Michel Waroquier, Veronique Van Speybroeck
Over the past two decades, metal-organic frameworks (MOFs) have matured from interesting academic peculiarities toward a continuously expanding class of hybrid, nanoporous materials tuned for targeted technological applications such as gas storage and heterogeneous catalysis. These oft-times crystalline materials, composed of inorganic moieties interconnected by organic ligands, can be endowed with desired structural and chemical features by judiciously functionalizing or substituting these building blocks...
November 20, 2017: Accounts of Chemical Research
Claire Miller, Daniel Kendrick, Andrew Shevitz, Ann Kim, Henry Baele, David Jordan, Vikram S Kashyap
OBJECTIVE: High-resolution fixed C-arm fluoroscopic systems allow high-quality endovascular imaging but come at a cost of greater scatter radiation generation and increased occupational exposure for surgeons. The purpose of this study was to evaluate the efficacy of two methods in reducing scattered radiation exposure. METHODS: There were 164 endovascular cases analyzed in three phases. In phase 1 (P1), baseline radiation exposure was calculated. In phase 2 (P2), staff used real-time radiation dose monitoring (dosimetry badges [RaySafe; Unfors, Hopkinton, Mass])...
November 6, 2017: Journal of Vascular Surgery
Oren M Tepper, Hayeem L Rudy, Aaron Lefkowitz, Katie A Weimer, Shelby M Marks, Carrie S Stern, Evan S Garfein
Virtual reality and augmented reality devices have recently been described in the surgical literature. The authors have previously explored various iterations of these devices, and although they show promise, it has become clear that virtual reality and/or augmented reality devices alone do not adequately meet the demands of surgeons. The solution may lie in a hybrid technology known as mixed reality, which merges many virtual reality and augmented realty features. Microsoft's HoloLens, the first commercially available mixed reality device, provides surgeons intraoperative hands-free access to complex data, the real environment, and bidirectional communication...
November 2017: Plastic and Reconstructive Surgery
Travis H Thompson, Christian Ochsenfeld
We introduce both rigorous and non-rigorous distance-dependent integral estimates for four-center two-electron integrals derived from a distance-including Schwarz-type inequality. The estimates are even easier to implement than our so far most efficient distance-dependent estimates [S. A. Maurer et al., J. Chem. Phys. 136, 144107 (2012)] and, in addition, do not require well-separated charge-distributions. They are also applicable to a wide range of two-electron operators such as those found in explicitly correlated theories and in short-range hybrid density functionals...
October 14, 2017: Journal of Chemical Physics
Anna-Katharina Meinecke, Paco Welsing, George Kafatos, Des Burke, Sven Trelle, Maria Kubin, Gaelle Nachbaur, Matthias Egger, Mira Zuidgeest
Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory, and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice...
November 2017: Journal of Clinical Epidemiology
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
Tasneem Dhansura, Nabila Shaikh
The anaesthesiologist's presence during interventional radiology (IR) is increasing due to increasingly ill patients and intricate procedures. The management of a parturient in IR suite is complex in terms of logistics of an unfamiliar procedure in an unfamiliar area. The literature available is largely written by radiologists with little attention paid to anaesthetic details and considerations. In the Indian scenario, in the absence of hybrid operating rooms (ORs), logistics involve transport of a parturient back and forth between the IR suite and the OR...
April 2017: Indian Journal of Anaesthesia
Park Jong-Hyun, Mun Jonghyeon, Shin Dong-Seung, Kim Bum-Tae
BACKGROUND: The integration of interventional and surgical techniques is requiring the development of a new working environment equipped for the needs of an interdisciplinary neurovascular team. However, conventional surgical and interventional tables have only a limited ability to provide for these needs. We have developed a concept mobile hybrid operating table that provides the ability for such a team to conduct both endovascular and surgical procedures in a single session. METHODS: We developed methods that provide surgeons with angiography-guided surgery techniques for use in a conventional operating room environment...
March 25, 2017: Turkish Neurosurgery
Jeffrey Abbott, Donhee Ham, Guangyu Xu
Electrical sensing of biomolecules has been an important pursuit due to the label-free operation and chip-scale construct such sensing modality can enable. In particular, electrical biomolecular sensors based on nanomaterials such as semiconductor nanowires, carbon nanotubes, and graphene have demonstrated high sensitivity, which in the case of nanowires and carbon nanotubes can surpass typical optical detection sensitivity. Among these nanomaterials, graphene is well suited for a practical candidate for implementing a large-scale array of biomolecular sensors, as its two-dimensional morphology is readily compatible with industry standard top-down fabrication techniques...
2017: Methods in Molecular Biology
Edin Nevzati, Javier Fandino, Bawarjan Schatlo, Michel Heimberg, Serge Marbacher, Luca Remonda, Ali-Reza Fathi
BACKGROUND: With the concept of the hybrid operating room gaining popularity, the authors adapted a hybrid angiographic suite with intraoperative computed tomography (iCT) to evaluate accuracy of pedicle screw placement in spinal fusion. This retrospective review examines how well iCT detected extrapedicular screw violation, to then allow repositioning and potentially avoid revision surgery. METHODS: A total of 36 consecutive patients underwent pedicle screw placement in posterior cervical, thoracic, and lumbosacral spinal fusions...
December 2017: British Journal of Neurosurgery
Hiten Mohanbhai Patel, Shubhabrata Banerjee, Shahzad Bulsara, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: Aberrant right subclavian artery is an uncommon entity incidence ranging from 0.5 to 2.5%. Management of thoracic aortic injury in the presence of such anomalies can be a challenge. We present here a case of traumatic aortic injury, which was incidentally found to have an asymptomatic aberrant right subclavian artery. The patient was managed by an endovascular repair of thoracic aortic injury with an endograft and a right carotid to subclavian artery bypass as a hybrid procedure...
May 2017: Annals of Vascular Surgery
V Karthik Nagareddy, Matthew D Barnes, Federico Zipoli, Khue T Lai, Arseny M Alexeev, Monica Felicia Craciun, C David Wright
Graphene oxide (GO) resistive memories offer the promise of low-cost environmentally sustainable fabrication, high mechanical flexibility and high optical transparency, making them ideally suited to future flexible and transparent electronics applications. However, the dimensional and temporal scalability of GO memories, i.e., how small they can be made and how fast they can be switched, is an area that has received scant attention. Moreover, a plethora of GO resistive switching characteristics and mechanisms has been reported in the literature, sometimes leading to a confusing and conflicting picture...
March 28, 2017: ACS Nano
Ze-Rui Zhao, Rainbow W H Lau, Peter S Y Yu, Randolph H L Wong, Calvin S H Ng
The advancement of imaging technology has recently facilitated single port minimally-invasive thoracic surgery techniques. Cone-beam computed tomography (CBCT) shows promising results in visualizing the target lesion and its surrounding critical anatomy, with an error of less than 2 mm. The integration of CBCT with the operating room (OR) to form the hybrid OR, provides unparalleled real-time imaging of the patient, which can be used with electromagnetic navigation bronchoscopy to confirm successful navigation and increase procedural accuracy particularly for small peripheral pulmonary targets...
October 2016: Journal of Thoracic Disease
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
April 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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