バイプレーン血管撮影装置と専用手術台との組み合わせによるハイブリッド手術室の初期使用経験

Preliminary Experience of a Biplane Flat Panel and Tailor-made Operating Table-equipped Hybrid Operating Room

Ⅰ．はじめに

　近年複雑な脳血管障害の治療に際し，フラットパネル血管造影装置を備えた手術室（hybrid operating room：Hybrid OR）の有用性が報告されている^2,4)．しかしながら，現在までに報告されているHybrid ORは，手術用ベッドの利便性やバイプレーン装置使用の可否，手術室稼働率などの点から理想的とは言いがたい^2,4)．今回われわれは，これらの点の改善を目指し，バイプレーン血管撮影装置と専用手術台を組み合わせた，国内でもまだ導入の少ないHybrid ORを導入したので，その初期使用経験を報告する．

　A hybrid operating room（Hybrid OR), where operative equipment and flat panel angiography are both available, is becoming common for complex cerebrovascular surgery. However, the current Hybrid OR remains suboptimal as it is not cost-effective and contains uncomfortable operating beds, and a single-plane flat panel. Therefore, we introduced a novel Hybrid OR system, which has a biplane flat panel detector and three mutually exchangeable tailor-made operating beds. In this article, we report our preliminary experience of this novel Hybrid OR, focusing on improved cost-effectiveness by the availability of diagnostic angiography and standard endovascular surgery, optimal selection of three different types of operating beds, and procedural workflow in individual hybrid cerebrovascular surgery.