Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neurosurgery, Karolinska University Hospital, Eugeniavägen 6, 4Th Floor, Solna, 17164, Stockholm, Sweden.
Acta Neurochir (Wien). 2023 Sep;165(9):2343-2358. doi: 10.1007/s00701-023-05756-7. Epub 2023 Aug 16.
Hybrid operating rooms (hybrid-ORs) combine the functionalities of a conventional surgical theater with the advanced imaging technologies of a radiological suite. Hybrid-ORs are usually equipped with CBCT devices providing both 2D and 3D imaging capability that can be used for both interventional radiology and image guided surgical applications. Across all fields of surgery, the use of hybrid-ORs is gaining in traction, and neurosurgery is no exception. We hence aimed to comprehensively review the use of hybrid-ORs, the associated advantages, and disadvantages specific to the field of neurosurgery.
Electronic databases were searched for all studies on hybrid-ORs from inception to May 2022. Findings of matching studies were pooled to strengthen the current body of evidence.
Seventy-four studies were included in this review. Hybrid-ORs were mainly used in endovascular surgery (n = 41) and spine surgery (n = 33). Navigation systems were the most common additional technology employed along with the CBCT systems in the hybrid-ORs. Reported advantages of hybrid-ORs included immediate assessment of outcomes, reduced surgical revision rate, and the ability to perform combined open and endovascular procedures, among others. Concerns about increased radiation exposure and procedural time were some of the limitations mentioned.
In the field of neurosurgery, the use of hybrid-ORs for different applications is increasing. Hybrid-ORs provide preprocedure, intraprocedure, and end-of-procedure imaging capabilities, thereby increasing surgical precision, and reducing the need for postoperative imaging and correction surgeries. Despite these advantages, radiation exposure to patient and staff is an important concern.
杂交手术室（hybrid-OR）将传统手术室的功能与放射科套房的先进成像技术相结合。杂交手术室通常配备有 CBCT 设备，具有二维和三维成像功能，可用于介入放射学和图像引导手术应用。在所有外科领域，杂交手术室的使用都在增加，神经外科也不例外。因此，我们旨在全面回顾杂交手术室的使用情况，以及神经外科领域特有的相关优点和缺点。
从创建到 2022 年 5 月，我们在电子数据库中搜索了所有关于杂交手术室的研究。将匹配研究的结果进行汇总，以加强当前的证据基础。
本综述共纳入 74 项研究。杂交手术室主要用于血管内手术（n=41）和脊柱手术（n=33）。导航系统是与杂交手术室中的 CBCT 系统一起使用的最常见的附加技术。报告的杂交手术室的优点包括即时评估结果、降低手术修正率以及能够进行开放和血管内联合手术等。提到的一些局限性包括增加的辐射暴露和手术时间。
在神经外科领域，杂交手术室在不同应用中的使用正在增加。杂交手术室提供术前、术中和术后成像功能，从而提高手术精度，并减少术后成像和修正手术的需要。尽管有这些优点，但患者和工作人员的辐射暴露是一个重要的关注点。
