Operating room radiography to transform surgery

New York 02 April 2010In a move that could change the way many patients undergo surgery, NewYork-Presbyterian Hospital has installed five state-of-the-art Siemens Artis zeego medical imaging systems that provide faster, more accurate 3D images of the body with a quality never before attainable. With more complete information, surgeons can better assess a patient's condition, devise a detailed surgical plan, and provide more targeted surgical treatment.

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NewYork-Presbyterian has more of these systems installed than any other hospital in the world and is the country's first to use the technology for neurological and colorectal surgical procedures. The Hospital is also using the Artis zeego to advance heart and vascular surgeries.

According to NewYork-Presbyterian surgeons, the radiographic imaging technology promises to transform the care of patients, with improved safety and outcomes, while stimulating innovation. The Artis zeego's robotic C-arm "senses" the location of the operating table, giving surgeons extraordinary flexibility to manoeuver the imaging system at almost every angle without moving the patient. As a result, internal organs can be seen from a "fly around" perspective in three dimensions, in minute detail.

"This technology is a major step forward. Previously, to obtain such images, we had to bring patients to a separate radiology suite. Now, high-quality imaging is available right in the operating room, giving us an amazingly clear picture of the patient's anatomy from any angle. This helps us ensure the highest quality of care", stated Dr. Jeffrey Milsom, executive director of the Center for Advanced Digestive Care and chief of Colon and Rectal Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and the Jerome J. DeCosse, M.D., Professor of Surgery at Weill Cornell Medical College. "Going forward, image procurement and analysis in the operating room will open up new avenues for minimally invasive surgical innovation and improved patient outcomes."

The newly opened Leona M. and Harry B. Helmsley Surgical Suite at NewYork-Presbyterian/Weill Cornell is the first in the country to use an Artis zeego system in conjunction with a BrainLAB VectorVision navigation system for neurological procedures. The system displays real-time 3D images of pre-operative scans on a touch-screen monitor and is equipped with two infrared cameras that track the patient's position in the operating room.

"The Artis zeego allows us to image the cervical and cerebral vessels of the brain at the time of surgery. Additionally, we are able to perform CT scan imaging of the brain where we need the information most - in the operating room", stated Dr. Howard A. Riina, co-director of Interventional Radiology at NewYork Presbyterian Hospital/Weill Cornell Medical Center, and associate professor of neurological surgery in neurology and radiology at Weill Cornell Medical College. "The goal is a more precise and safer surgery."

The Vivian and Seymour Milstein Family Heart Center, which opened in January at NewYork-Presbyterian Hospital/Columbia University Medical Center, features an Artis zeego–equipped operating room that allows surgery and interventional cardiology procedures to be done consecutively in the same room. The hospital was the first in the New York area to perform this kind of hybrid procedure.

"What previously involved two separate procedures can now be done in one", stated Dr. Mathew Williams, surgical director of cardiovascular transcatheter therapies, and a cardiac surgeon and interventional cardiologist at NewYork-Presbyterian/Columbia; and assistant professor of surgery (in medicine) at Columbia University College of Physicians and Surgeons. "Oftentimes the best approach for a patient involves a combination of coronary artery bypass and stenting. By performing both at the same time, we are not only making it more convenient, but we are reducing the stress of surgery and improving recovery time."

The imaging technology can also be used after a standard bypass to ensure the bypass graft is providing adequate blood flow to the heart. Published research has shown that this approach can reduce the number of complications.

All of these imaging technologies are co-ordinated and presented to the surgeon through a "wall of knowledge" - an array of high-definition video monitors that displays patient medical information along with images from the operating room. The Patient-Aware Operating Room (PAOR), a new patient safety system from LiveData and Karl Storz Endoscopy-America, also allows for videoconferencing between remote areas of the hospital, such as surgical pathology, and permits broadcast of live video for teaching purposes.

The technology also helps track and anticipate events. For instance, it will display trends in the patient's vital signs and will prompt the surgeon during the operation and notify the anaesthesia team as to timing of a drug dose.

NewYork-Presbyterian Hospital, based in New York City, is the United States' largest not-for-profit, non-sectarian hospital, with 2353 beds. The hospital has more than 1 million inpatient and outpatient visits in a year, including more than 220.000 visits to its emergency departments - more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centres: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division.

One of the largest and most comprehensive health care institutions in the world, the hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the nr. 1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.


Source: New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

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