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The Hybrid OR of the Future ASSISTMAGAZINE Innovative Interventional Treatments The hybrid OR of the future VIDEO-ASSISTED THORACIC SURGERY OF LUNG NODULES UROLOGY & INTERVENTIONAL RADIOLOGY COLLABORATION DOSE REDUCTION RESULTS FROM THE REVAR STUDY Magazine#6 Editorial DISCOVER A WHOLE NEW WORLD IN IMAGE-GUIDED SURGERY Jean-François Drouet France Schwarz Image Guided Therapy Interventional & Hybrid OR Director Europe Marketing Manager Europe DiscoveryTM IGS 7 OR Dear Reader, One suite, endless possibilities The fields of Interventional Imaging and Minimally-Invasive Surgery have never been so close. Hybrid Operating Rooms (HOR) are spreading at a fast rate across hospitals in the world, and more and more specialties are discovering the benefits of such innovative environments. HOR are evolving from dedicated CardioVascular ORs to multidisciplinary environments, where Thoracic Surgery, Urology, Interventional Radiology and other specialties are performing advanced Precision 5 reasons why Discovery IGS 7 OR is a highly Therapy. Key considerations for building an HOR, such as having a flexible imaging solution to enable flexible Hybrid OR solution diverse clinical setups, meet stringent OR hygiene standards, maximize OR utilization, and improve clinical outcomes through intra-operative 3D imaging and augmented reality 3D guidance are driving hospitals investments. In this edition of the ASSIST magazine, dedicated to the future of the hybrid OR, we aim to FLEXIBILITY FOR DESIGNED MAXIMISE OR INCREASE SURGICAL IMPROVE OUTCOMES highlight innovative practices and novel usages from our customers around the world using DIVERSE CLINICAL TO MEET STRINGENT UTILISATION PRECISION WITH WITH AUGMENTED SETUPS OR HYGIENE INTRA-OPERATIVE 3D REALITY 3D GE advanced solutions, such as the Discovery IGS 7 and Discovery IGS 7 OR, as well as ASSIST No compromise in STANDARDS GUIDANCE Augmented Reality Image Guidance. From combining two procedures in one, or bringing together Mobile robotic gantry surgical table Wide bore offset C-arm with customisable Rail-free ceiling integration with enables easy CBCT Intuitive ASSIST two specialties for the benefit of the patient, to finding cutting-edge solutions to address clinical parking positions, to provides flexibility to Maquet Magnus OR imaging for essentially solutions help to challenges, these articles are highlighting how Surgeons, Interventional Radiologists and other position the gantry design the location of table system to enable every patient and significantly reduce healthcare providers are pushing the boundaries of imaging today to drive better patient care. where you need it, so the laminar flow, virtually any surgery every procedure. CBCT radiation dose and it works around you, monitors, surgical and interventional imaging helps increase contrast media, while not the other way lights and rad-shield specialty in one room1. technical success and reducing procedural We would like to thank our clinical partners for sharing their best practices in this ASSIST around. without any reduce secondary time3,4. magazine, and wish you a good reading! interference. interventions at 30 days2. 1. Maquet Magnus table is sold by Getinge. Discovery IGS 7 OR is fully integrated with the 360° 4. Outcomes will vary depending on the system, settings, clinical task, patient size, anatomical location, radiolucent flat table top 1180.16A2/F2 and with the Universal table top 180.10A0/F0 with attachment clinical practice and ASSIST solutions. Performance obtained from following publicly available peer Jean-François Drouet and France Schwarz 1180.37A0/F0. The flat table top is suited for interventional, minimally invasive surgery and reviewed papers: Novel integrated 3DCT and fluoroscopy fusion for LAA closure. Value of Image Fusion conventional open surgical procedures. The Universal tabletop is suited for minimally invasive surgery Coronary angiography for the detection of CABG, Impact of Hybrid rooms with Image fusion on and conventional open surgical procedures. radiation exposure during endovascular Aortic repair, Percutaneous Bone Biopsies: comparison 2. Tenorio et al. Impact of onlay fusion and cone beam computed tomography on radiation exposure and between CBCT and CT guidance, Significant patient radiation exposure reduction during complex liver technical assessment of fenestrated-branched endovascular aortic repair. Journal of Vascular Surgery IR procedures using a new generation angiography imaging room, Comparison of the number of image 2018. acquisitions and procedural time required for TACE of Hepatocellular Carcinoma with and without 3. ASSIST solutions are composed of multiple medical devices. For more information, please refer to tumor feeder detection SW. GEHC’s web site. www.gehealthcare.com/assist © 2019 General Electric Company – All rights reserved. GE, the GE Monogram, and Discovery are trademarks of General Electric Company. Editorial | ASSIST 3 Table of Contents Table of Contents Local Contact Information: GE Healthcare Buc 283, rue de la Miniere 78533, Buc Cedex, France Chief Editor: France Schwarz MAGAZINE Editorial Team: Dustin Boutboul, Mathilde ASSIST Dauchez, Jean-François Drouet, Paul Ayestaran, Thijs ter Mors, Aïcha Zammouri, Cecilia Félix. Design: Nathalie Ollivier ‘ Printer: Groupe Lecaux Imprimeries HandiPRINT Many thanks to our contributors : Pr. Pierre Bigot, France Dr. Antoine Bouvier, France Pr. Bob Geelkerken, The Netherlands Dr. Dick Gerrits, The Netherlands Dr. Simon Rouzé, France Dr. Brian Kouri, USA Dr. Nicolas Louis, France Dr. Eva-Line Decoster, Belgium Pr. Stéphan Haulon, France* Dr. Adrien Hertault, France Pr. Hervé Rousseau, France Dr. Robert Rhee, USA* * These contributors are paid consultant for GE Healthcare, but they have not been paid for the interviews here and did not receive orientations for them. 08 30 Hybrid and collaborative New imaging workflows approaches 22 30 Interventional Oncology: the 08 Fostering Team Collaboration Fourth Pillar in Oncology Care and Medical Innovation Focus on a new specialty in 36 When Augmented Reality helps in a Hybrid Room the hybrid OR Salvage Limbs at the 16 Case Report: Partial Nephrectomy Franciscaine Private Hospital, after Selective Embolization of Tumor Nimes, France 22 Video-Assisted Thoracic Surgery in the 48 Vessels in a Hybrid Operating Room 42 Case Report: Treatment of Hybrid Operating Room for Lung Focus on new clinical 18 Case Report: Treatment of Peripheral Nodule Resection Chronic Total Occlusion (CTO) of Arterial Occlusive Disease (PAOD) and Femoro-Popliteal Arteries using evidence 28 Case Report: Wedge Resection of a Bowel Ischemia in a single session Vessel ASSIST Left Lower Lobe Nodule with Video- using DiscoveryTM IGS 740 Assisted Thoracic Surgery (VATS) under 45 Case Report: Endovascular 48 Reducing Radiation Dose during CBCT and Image Fusion Guidance Recanalization EVAR in the Hybrid Operating of the Crural Artery using CO2 Room: the REVAR study with Discovery IGS 730 4 ASSIST | Table of Contents Table of Contents | ASSIST 5 ne trace through the occlusion, fuse it on the live fluoroscopy with 2D/3D fusion, helping to reduce the risk of perforations or miss POWER UP PATIENT CARE POWER UP YOUR POWER UP CLINICAL CAPABILITIES PRODUCTIVITY Your patients benefit from AND SERVICE LINE ASSIST Solutions greater diagnostic accuracy The ASSIST portfolio and therapeutic ASSIST gives you the clinical provides intuitive planning, effectiveness with minimal information to let you plan, designed to make your exposure. guide and assess procedures easier and more www.gehealthcare.com/assist interventional procedures. efficient. EVAR ASSIST 2 * Vessel ASSIST ** Needle ASSIST *** Liver ASSIST V.I.**** PCI ASSIST ***** Valve ASSIST 2 ****** Designed by surgeons and Designed by surgeons and With Needle ASSIST, you can Liver ASSIST V.I. significantly Now you can perform long, complex Valve ASSIST 2 provides enhanced interventional radiologists, EVAR interventional radiologists, Vessel perform complex percutaneous improves sensitivity of identifying PCI procedures with the same planning and real-time visualization ASSIST 2 provides a fully integrated ASSIST provides easy to use and procedures in the angio room. It tumor feeding vessels so you can precision and confidence as routine enabling you to position the valve workflow to plan, guide, and assess accurate planning and guidance provides real-time visualization of diagnose and perform cases – without increasing dose4. and guide devices with precision. complex EVAR procedures. EVAR tools. For example, Vessel ASSIST needle positions in the 3D space by sophisticated TACE procedures PCI ASSIST significantly helps to 3D contour rendering further ASSIST 2 consists of a dedicated enables you to create and edit a automatically fusing CBCT data with far greater confidence3. With improve contrast and visibility. You improves intra-aortic visualization. planning application to perform and vessel centerline, trace through an over live fluoroscopic images. This Virtual Injection, Liver ASSIST V.I. can clearly see even small details to You can choose the appropriate save key anatomical information occlusion, and fuse it on the live enables precise needle trajectories, simulates in real-time your accurately position and deploy x-ray projection with no use of and measurements for sizing, along fluoroscopy with 2D/3D fusion. with over 1mm accuracy1. With the injection before you treat. This stents thanks to advanced stent contrast media and minimal with a dedicated image fusion guided-workflow instructions, you real-time
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