GE Healthcare NuBOOM - Manual (Page 3)

St George’s is a large university
teaching hospital in the southwest
of London, serving a population of
around four million people.
The hospital has over nine hundred
beds, making it one of the countries
principal teaching hospitals.
St George’s provides services for
many specialties including vascular
surgery, cardiac surgery, neurosurgery
and renal transplantation.
His clinical interests are in the
treatment of complex aortic disease
and minimally invasive vascular
surgery in which the SGVI has an
international reputation. Research
interests include health service
outcome research, clinical trials
and translational investigations into
aortic disease. Professor Thompson
is the editor of the Oxford Textbook
of Vascular Surgery. He is the
Secretary of the British Society for
Endovascular Therapy and a Council
Member of the Vascular Society.
GE imaging systems
bring flexibility
to OR facilities at
St George’s Vascular
Institute
There is a growing trend towards minimally
invasive endovascular aortic repair (EVAR),
reflecting the clinical and cost benefits
this technique brings. St George’s Vascular
Institute already carries out around 240
endovascular aortic procedures a year,
and has recently installed a full GE OR suite
solution combining articulating monitor
docking system, an OEC* 9900 Elite MD
motorized C-arm system and a Stille ImagiQ™
table into a vascular operating theatre to
increase the flexibility of its facilities for aortic
endovascular procedures. Matt Thompson,
Professor of Vascular Surgery at St George’s,
describes the new set-up and discusses his
initial impressions of this flexible approach
to configuring operating rooms.
A flexible
imaging solution allows
the room to be completely
reconfigured for open
surgery or endovascular
techniques.
......
‘‘ ‘‘
It is absolutely
crucial to have more
than one monitor
so that every member
of the team is able to
look at the angiographic
and ultrasound images
simultaneously… ..............
‘‘ ‘‘
Using the OEC 9900 Elite MD motorized C-arm,
the surgeons can move both the arm and Stille imagiQ
table themselves, which has led to decreased operating
times and also a slight reduction in radiation doses.
‘‘
‘‘
The NuBOOM has
integrated well into our
existing theatre structure…
............
‘‘
‘‘
St George’s is a large, busy
university teaching hospital in the
southwest of London with approximately
a thousand beds, serving a population
of around 1.3 million locally, plus an
additional 3.5 million patients referred from
the surrounding area. St George’s Vascular
Institute has an international reputation in
the treatment of complex aortic disease,
and has a special interest in minimally
invasive procedures, especially
endovascular procedures of the aorta.
There is no need to make structural
changes because of the system’s
floor-mounted design. Retrofit your
operating room in two days:
eliminating downtime while still
allowing for future improvements
and expansions. The software behind the touch screen
interface allows surgeons and operating
staff to view information and route
images from various inputs on up to six
system monitors as well as direct
images to external archiving systems
and printers.
The decision was made to upgrade the imaging
facilities of the vascular department’s
operating theatre. Changing to a flexible
imaging management system and replacing
an existing OEC 9800 system with an OEC
9900 Elite MD motorized C-arm would allow
the room to be configured for open surgery
or endovascular techniques. This also
presented an ideal opportunity to improve
monitoring options, giving surgeons the
ability to integrate other imaging modalities,
such as ultrasound and endoscopic images.
The complex endovascular procedures that
are now undertaken at St George’s often
require two or more surgeons operating at
the same time, not only on each side of the
patient, but also using femoral and brachial
access. It is absolutely crucial to have more
than one monitor so that every member of
the team is able to look at the angiographic
images simultaneously to plan the progression
through each case.
An imaging management system is ideal
for this and the compact NuBOOM system
has integrated well into the existing theatre
structure at St George’s, providing four
screens. Importantly, theatre, anaesthetic
and surgical staff were involved in defining
the configuration of the system at installation,
so that the pillar and screens were optimally
positioned to give access to information to
any member of the team.
One of the main advantages of the NuBOOM
system is the extra space it provides;
accessories for the C-arm can be placed on
the system, removing clutter from around
the operating table, and the monitors are
suspended above, making it much easier
and more comfortable for colleagues to
follow the procedure.
The NuBOOM can relay different sources of
video input to each of the monitors at the
same time. The system is very flexible and
monitors may be set up, with full or split
screens. The usual preference at St George’s
is to have ultrasound images at the start of
the procedure on two monitors and
angiographic images on the other two.
Midway through an endovascular procedure,
there will generally be angiographic images
with or without the CT on all four monitors.
St George’s carries out a large number of
complex endografts that require different
projections and magnifications throughout
the procedure.
“Using the OEC 9900 Elite
MD motorized C-arm, the surgeons can
move both the arm and imagiQ table
themselves, which has led to decreased
operating times and also a slight reduction
in radiation doses.
”
The ability to modify the imaging according
to requirements by using the surgeon-
controlled panel is essential. Regard to
magnification, the surgeon can ensure that
the low-dose function is on for the vast
majority of the time and can also reduce
dose using collimation features.
The OEC OR suite solution has now been
operational at St George’s for a year, and
is used five days a week for the majority
of the department’s aortic endovascular
procedures. This flexible mobile system has
proven to be an excellent solution for
performing endovascular procedures within
an existing operating theatre.
The tower provides equipment storage
to remove clutter and to get cables and
carts off the crowded operating room
floor — freeing up valuable space.
The two articulating arms are easily
maneuvered in and out of the surgical
field as needed.
This medical imaging communication
solution can be adapted for each
procedure and for each surgeon
and operating team, providing
a customizable field-of-view for a
comfortable surgical environment.
Professor
Matt Thompson
is the Professor
of Vascular
Surgery at
St Georges
Vascular
Institute (SGVI).