Vermont's first hybrid operating room is up and running at the state's largest hospital. And for many patients that can mean one stop shopping: two different procedures can be done during one visit to the OR.
Vascular surgeon Andy Stanley is first up on this day, performing an endarterectomy in Fletcher Allen Health Care's new hybrid operating room. Simply put, he's cleaning out the plaque from narrowings in the patient's left femoral artery. She has limited blood flow and without intervention, could ultimately lose her limb.
"So, this is the tightest region of narrowing right here, which is where Dr. Stanley is operating as we speak. And just above in the artery of the pelvis, called the iliac artery, are two additional areas of narrowing that also need to be treated with a stent," said Dr. Christopher Morris, an interventional radiologist at FAHC.
And that's where Morris comes in. Stanley performs the open surgical procedure, and then Morris steps in for a percutaneous procedure, where access is normally done via needle-puncture of the skin. Those are typically done separately in an angiography suite-- better known as the cath lab-- where fixed imaging guides the catheter carrying the stent. But now that imaging is available in a sterile operating room with a giant C-arm and both medical procedures can be done at one time. Hence, the name hybrid.
Here, the stent is released and the blood flow improves instantly.
"Previously, she would have had a diagnostic study that determined her disease and she would have then required a bigger operation-- something called an aortofemoral bypass-- where we would bypass from the abdomen, the aorta down to the groin," Stanley explained. "Now the difference is this woman is going to awaken, we'll have her eating and drinking by this afternoon and she'll probably be gone-- as long as she's comfortable-- by tomorrow or the next day."
Medical advancements are allowing these less invasive procedures in sophisticated settings. For patients that means less risk, shorter hospital stays and faster recovery. It means one trip to the hospital instead of two. And for trauma patients, the hybrid operating room could mean the difference between life and death.
"For the trauma population that we service, this can save lives. There's just no doubt about it. We have a bleeding patient; somehow you have to diagnose what the problem is, send them to radiology and then to the OR-- can be dangerous and take too long. So, to treat the patient while you're diagnosing the problem will absolutely save lives," said Dr. Marion Couch, the interim chief of surgery at FAHC.
The hybrid operating room has been a decade-long project at Fletcher Allen. It's allowing doctors to work together across disciplines and giving patients more lifesaving options for care.
There are less than 200 hybrid operating rooms across the country.
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