10 Hospital management
A hybrid room is an operating room where treatments are performed in the form of a hybrid (combination): minimally invasive procedures with the possibility of performing full surgical procedures (including cardiosurgical procedures).
Abstract
The rapid development of minimally invasive techniques, as well as imaging systems with the possibility of image fusion from various devices, and the possibilities of integrating and managing medical devices have made the traditional operating room concept find its complement in the form we call hybrid room. It is therefore an operating room where treatments are performed in the form of a hybrid (combination): minimally invasive procedures (e.g., coronary vessel diagnostics—coronary angiography and angioplasty treatment) with the possibility of performing full surgical procedures (including cardiosurgical procedures). The concept of a hybrid room is quite ambiguous; there are no detailed requirements or guidelines regarding its equipment. It is assumed, however, that such a room must be equipped with a device enabling blood vessel imaging such as an angiograph (oneor two-plane). Quite often, the concept of hybrid type rooms is also used when there is a large diagnostic device (e.g., MRI or CT scanner) in the operating room. These and other devices (such as endoscopic imaging systems, intraoperative microscopes, and ultrasound scanners) should be able to interact and communicate with one another, for example, by means of data exchange or by overlapping (merging) images. The combination of many techniques significantly improves diagnostic quality, increases the precision and effectiveness of treatments, and makes treatments shorter and less invasive. The large accumulation of equipment, however, means that rooms of this type need special methods of equipment planning and device placement, or even the way of moving and communicating between the staff of various specialties (surgeons, anesthesiologists, consultants of selected fields, and nursing and technical staff). A hybrid room is therefore a specific place where ergonomics and regulations from many fields of medical engineering should be taken into account (e.g., radiological protection, medical gases, ionizing radiation, electromagnetic field, complicated laminar airflow supply systems, and other climatic conditions). Among other devices, in addition to the aforementioned equipment, the hybrid room usually includes the following: a surgical lamp (usually a dual head with the ability to record and transmit audio and video signals); a set of (anesthesiological and surgical) power columns equipped with medical gas outlets, power sockets, fasteners, apparatus for general anesthesia, and vital signs monitoring; resuscitation and anesthetic equipment (defibrillator, suction pump, respirator, and set of infusion pumps); electrosurgery system (available in many forms, e.g., as a classic electrosurgical knife, jet surgery knife, plasma knife, ultrasonic knife, or using other technology); cardiology equipment (counterpulsation controller, turbine hemopump, extracorporeal