Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The last two decades have seen a paradigm shift in the treatment of vascular related diseases from once traditional open surgical repairs to the entire vascular tree being amenable to percutaneous interventions. Neither the classic operating room nor the conventional angiography suite is optimal for both open surgery and endovascular procedures. Important issues for the vascular hybrid operating room include quality of the imaging equipment, radiation burden, ease of use of the equipment, need for specially trained personnel, ergonomics, ability to perform both open and percutaneous procedures, sterile environments, as well as quality and efficiency of patient care. The most important feature of working in a dedicated hybrid vascular suite should be the ability to attain best treatment of vascular patients. Whether the interventional radiologist or the vascular surgeon uses the facilities is of less importance. Establishment of an endovascular operating room suite has the benefit of a sterile environment, and the possibility of performing hybrid procedures and conversions when necessary. Moreover, angiography immediately before treatment gives contemporary anatomical information, and after treatment provides quality control. Consequently, better quality and service can be provided to the individual patient. These changes in the treatment of vascular disease require that a new type of vascular specialist, named ‘vascular hybrid surgeon’, trained to perform both endovascular and open surgical procedures in this highly complex patient group.U posljednja dva desetljeća primjećuje se pomak u liječenju vaskularnih bolesti od tradicionalno otvorenih kirurških zahvata prema perkutanoj intervenciji cijelog vaskularnog stabla. Niti klasične operativne dvorane, a niti konvencionalne angio dvorane nisu optimalne za izvođenje otvorene operacije ili za endovaskularne zahvate. Glavne značajke vaskularne hibridne operativne dvorane obuhvaćaju kvalitetnu opremu za snimanje, radijacijski štit, opremu za jednostavnu upotrebu, potrebu za dobro izučenim kadrom, ergonomičnost, mogućnost odvijanja otvorenih i perkutanih zahvata, sterilnu okolinu, kao i kvalitetu i učinkovitost bolesničke skrbi. Najznačajnija značajka rada u hibridnoj vaskularnoj operacijskoj dvorani trebala bi biti mogućnost pružanja najbolje operacije bolesniku s krvožilnom bolešću. Manje je važno tko će opremu upotrebljavati, intervencijski radiolog ili vaskularni kirurg. Uspostava jedne endovaskularne operativne dvorane ima prednost sterilne okoline, mogućnost izvođenja hibridnih zahvata, te ako je potrebno i konverzije. Također, angiografija učinjena neposredno prije operativnog zahvata pruža točnije anatomske informacije, a nakon zahvata pruža bolju kontrolu kvalitete. Posljedično, bolja kvaliteta i usluga može se ponuditi svakom pojedinačnom bolesniku. Takve promjene u liječenju bolesnika s bolešću krvnih žila zahtijevaju i novi profil vaskularnog kirurga nazvan “vaskularni hibridni kirurg” koji mora biti osposobljen u izvođenju endovaskularnih, ali i otvorenih operativnih zahvata kod iznimno složene skupine bolesnika
