ISMETT: Inauguration of the new hybrid operating room

An innovative hybrid operating room was inaugurated on April 19, 2016 at ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione) in Palermo in the presence of Baldo Gucciardi, Sicilian Regional Health Commissioner, Rosario Crocetta, President of the Sicilian Region, Patrizia Monterosso, Secretary General of the Sicilian Region, and Angelo Luca, Director of ISMETT.
The evolution of imaging techniques and information systems has allowed the integration of diagnostic imaging with operating room (OR) procedures. As a result, it becomes necessary to have a single space that hosts typical imaging equipment and technology while at the same time guaranteeing the typical operating room features of sterility and organization. Such a space is called a hybrid OR and hosts a multidisciplinary team (imaging specialists, interventional radiologists, surgeons, hemodynamics specialists).

In a hybrid OR, a cardiac aortic valve can be implanted without opening the chest and without need for extracorporeal circulation. Through the femoral artery, a catheter leads the valve to the heart using radiology images, and the system is anchored in the right position to replace the dysfunctional valve. This must be done under sterile conditions and in a room where a surgical team and extrcorporeal circulation are readily available if a complication arises and open-heart surgery becomes necessary.

These technological advances are changing the level of invasiveness of surgery, thus reducing the number of traditional invasive procedures, and therefore the risk of complications, with a lighter biological and psychological impact on the patient. This significant reduction in terms of risks and complications has made treatment possible for patients that, due to their age or comorbidities, could not be treated with traditional surgery.
“Hybrid” interventions, i.e., an interventional procedure combined with surgery, are also possible. This reduces the risks for patients, with lower times for surgery, anesthesia, and extracorporeal circulation.

The hybrid room is used for the treatment of the following diseases:

• valvular diseases in patients at high surgical risk;
• vascular diseases of the thoracic and abdominal aorta;
• rhythm disorders in patients with chronic atrial fibrillation;
• coronary heart disease;
• congenital diseases.