Hybrid Operating Room
Augusta University Health and Philips Partnership
![video thumbnail](/-/media/project/wellstar/augusta-migrated/default-placeholder-img/img-placeholder.jpg?la=en-us&rev=218cebd69ec6434786e927b18363175c&hash=880A9BD4093CC3841D6DAFE7B5F34A0A)
Augusta University Health and the Georgia Cancer Center are proud to offer the hybrid operating room as an option for lung cancer patients needing surgery to remove their tumor(s). Representing a paradigm shift in thoracic surgery, the hybrid operating room combines three techniques into a single appointment eliminating multiple clinical visits for improved patient experience and outcomes.
Thanks to an investment by ;Augusta University Health, a surgeon can now diagnose and treat patients with lung cancer faster than is possible in a traditional operating room. Before the hybrid OR opened, it could take up to six weeks just to get a diagnosis. Having the hybrid OR and all of its technologies at Augusta University Health allows Dr. Carsten Schroeder and his team to tailor the patient’s care plan in one day instead of having to schedule multiple follow-up appointments.
Working with Philips through a unique long-term partnership model that allows for co-creating of clinical solutions, Augusta University Health opened its hybrid operating room in May 2017. It brings three techniques into a single space: navigational bronchoscopy, allowing Schroeder to locate tumors in a person’s lungs percutaneous biopsy, which gives Schroeder the ability to biopsy small section of a lesion to see if it’s cancerous; and fiducial marker placement mark the tumor to make sure the entire mass is removed and video-assisted thoracoscopic surgery, allowing him to use a tiny video camera to operate inside a person’s chest cavity. In the hybrid OR, all three techniques are assisted by intra-operative cone beam CT imaging, which captures images of the inside of a person’s chest and allows Schroeder to see the tumor and form the best surgical strategy to biopsy or remove it safely.
CT-Scan augmented Navigational Bronchoscopy
Traditionally, navigational bronchoscopy has been performed as a separate procedure from Video Assisted Thoracic Surgery (VATS), typically by a pulmonologist. Navigational bronchoscopy is now an accepted standard of care when approaching a tumor inside the lung with typical biopsy accuracy at approximately 70% The availability of cone-beam CT in the hybrid operating room allows Dr. Schroeder to increase his biopsy accuracy to more than 85%.
CT-Scan guided Percutaneous Biopsy
Rather than an interventional radiology referral, a percutaneous biopsy can be performed in the hybrid OR using the cone-beam CT scan and a dedicated fluoroscopic guided techniques. Using the cone-beam
CT data, the tumor inside a patient’s lung is segmented digitally to allow the images to be analyzed and to determine the boundaries of the nodule.
Fiducial Marker Placement minimally invasive Lung Resection (iVATS)
Using the cone-beam CT system, fiducial markers, which are radio-opaque markers, are placed in and around the tumor to allow the surgeon to identify the section of the lung that must be removed to confirm the entire tumor was removed. Intraoperative cone-beam CT associated with augmented reality during pulmonary resection has additionally shown to be useful for confirming appropriate resection margins.
Dr. Schroeder is one of a handful of thoracic surgeons in the country using the cone beam CT scan option as part of a patient’s care plan for lung cancer diagnosis and treatment. Since moving his team into the hybrid OR in May 2017, Dr. Schroeder has been collecting data on the outcomes of his patients. The data compiled included 25 patients. His findings, which he said show a paradigm shift in patient care, were published in Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery in August 2018.
If you have questions or need more information about our treatments and services, please contact the Thoracic Team's nurse navigator, Stephanie Turner.