High-tech hybrid OR opened at Abington
A longtime wish list item for some Abington Memorial Hospital surgeons is changing the way some conditions can be treated.
The new $3.5 million hybrid operating room provides specialists with the ability to perform catheter-based, minimally invasive work and full surgical interventions in one place, allowing for more teamwork and the treatment of more complex cases, according to two who lobbied for the facility, vascular surgeon Dr. Terry Sullivan and cardiothoracic surgeon Dr. Maurico J. Garrido.
The room is designed to allow vascular surgeons, cardiothoracic surgeons, interventional cardiologists, neurosurgeons and neuro-interventionalists to work together, according to a press release from the hospital.
It allows for “two different ways of working on a body using the same place at the same time,” said Garrido, surgical director of the hospital’s Heart Rhythm Center.
“For the last decade or so there’s been a transformative, quiet revolution in the way we care for vascular patients, with more procedures using minimally invasive techniques,” said Sullivan, director of vascular surgery services. Some are hybrid procedures involving both open surgery and catheterization techniques using sophisticated imaging with X-ray guidance.
The hybrid OR “provides the best of both worlds,” Sullivan said; “a high-quality imaging system in an operating room setting with sterility and anesthesia capability.”
“It allows us to do in a more sterile setting cases with a much higher degree of complexity,” he said, such as an aorta aneurism requiring detailed imaging and open surgery capability.
An aneurism occurs when the wall of an artery thins, posing a risk of rupture, which can cause fatal bleeding, the Fort Washington resident said. By inserting a covered stent with X-ray guidance, the aneurism is no longer under pressure so it stops growing, Sullivan said.
In the past, a huge incision would be made in the chest or abdomen to place a stent, requiring a longer and more painful recovery, he said. Today, a minimally invasive procedure using guide wires to deploy a stent requires a 2-inch incision in the upper thigh, resulting in less pain and much quicker recovery.
The hybrid OR “allows us to use a more team approach with cardiovascular diseases,” he said, and “improves proficiency and ultimately the outcomes.”
A team approach would involve aorta problems in the upper thoracic region, where there may be cardiac issues, Sullivan said.
“It allows us to treat the consequences of dissections” — a split in the wall of the aorta, “faster and better,” Garrido said.
The room also has a “far superior” imaging system,” allowing doctors to “do procedures with a higher degree of precision, certainty and safety,” Sullivan said. It also reduces the amount of radiation exposure to patients and staff.
State-of-the-art imaging technology, including 3D monitors that allow for overlaying MRI and CT scan imaging provide a surgeon with a 3D view “while trying to put a stent in place,” Sullivan said.
“It maximizes the ability to see well for minimally invasive heart surgery,” Garrido added.
Sullivan said he lobbied for the hybrid OR for eight years and after partnering with the cardiovascular surgeons was able to get Abington Memorial to make the investment.
He has used the new OR, named for the late V. Paul Addonizio, previous chief of cardiovascular surgery at AMH, “a lot” since it was completed in October. “A lot of higher complexity procedures are planned for that room,” he said.
Aneurisms in arteries that lead to kidneys or other vital organs require specialized stent systems, Sullivan said, and the availability of the hybrid OR “will propel us to the next level, to take on more complex cases.”
One example is a new technique, which can be done in place of a traditional valve replacement, called transcatheter aortic valve replacement, in which entry is made through the groin and a valve is deployed on a stent, Garrido said.
“We are in the late stages of bringing that here to Abington Memorial,” the Jenkintown resident said. “You need to have a hybrid OR … the proper training is next.
“Today you need to be able to have a broader repertoire for vascular and cardiac treatments.”
“It’s a big commitment,” Sullivan said, noting the only other hybrid OR in the immediate area is at the Hospital of the University of Pennsylvania.