Intraoperative imaging and image-guidance in the hybrid operating room: benign bone tumors and bone metastases

Thomas van Steenbergen
Promotor J.J. Fütterer and M.M. Rovers
Copromotor I.C.M. van der Geest
Institute Radboud University, Nijmegen, The Netherlands
Date September 11, 2024

The hybrid operating room (OR) is a specialized OR that combines a traditional OR with the latest intraoperative imaging technology. The hybrid OR, with all its facilities, is more expensive than an angiography suite or a standardly equipped OR. It is important that these higher costs are justified by added benefits or cost reductions due to a more effective treatment that only the hybrid OR can provide. An important challenge is to find these applications that could potentially benefit from the high-end facilities of the hybrid OR.

(Cardio)vascular surgery, neurosurgery and traumasurgery were early adopters of hybrid OR procedures, and orthopaedic oncology may also benefit from using an hybrid OR. Medical imaging plays a key role in the treatment of both primary bone tumors and bone metastases (i.e. secondary bone tumors). Imaging provides the most important input for almost every procedure. Clinicians, however, have to cognitively translate all this information to the patient. Although years of experience may allow them to perform these procedures on a very high level, the accuracy of this translation may be improved.

We have performed some pilot studies as to explore the potential benefits of the hybrid OR in orthopaedic oncology, i.e. benign bone tumors and bone metastases. In a pilot or feasibility study, a technological procedure can be optimized, the safety and feasibility of the procedure can be assessed based on predefined outcomes, and clinical data can be gathered for later investigation of its effectiveness. The overall aim was to explore the feasibility of using and combining intraoperative imaging and image-guidance, with procedure planning and software workflows, in the hybrid operating room for benign bone tumor surgery and bone biopsies.

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