Shaping the Hybrid Future

Hybrid ORs Offer an Additional Benefit for Both Patient and Surgeons


Professor Jacques Marescaux, France, has revolutionized surgery and continues to push the envelope with unprecedented research and training ideas. He believes that hybrid ORs and augmented reality in surgery can improve patient care in the future.

How would you define a hybrid operating room?
Marescaux: You always have a treatment to propose to your patient. Especially in the case of cancer. We can propose flexible endoscopy, laparoscopic surgery, or interventional radiology. During the operation, surgeons want every possibility to take a closer look inside the patient. Using flexible endoscopy plus surgery, or flexible endoscopy plus 3D image guidance, or interventional radiology plus surgery – that is the idea of the hybrid operating room.

How can we optimize patient care in the future?

Marescaux: One core topic in optimizing patient care is the availability of all patient data from before, during, and after surgery, along with the option of combining this data. Several projects are underway that aim to superpose image data from different imaging modalities. The fusion of image data from an endoscopic camera with DynaCT data, and the fusion of ultrasound images with preoperative CT data are both particularly valuable for minimally invasive procedures.


What advice would you give to decision-makers planning an operating room?
Marescaux: The most important thing is to have enough space for all the devices and to give the team access to the patient. It is impossible to know what kind of equipment we will need for each surgical discipline in the future. But for general surgeons, it is important to collaborate with several disciplines on the same platform. If you can perform several steps in one operation, you don’t need two or three anesthesias for the patient.

What skills will surgeons of the future need?
Marescaux: In the USA, there is a lot of specialization, but the majority of surgeons are generalists working in smaller hospitals. I think that surgeons in Europe are more specialized today. One example is that we have “hepatobiliary surgeons” working with surgeons who only do transplants. And the future will probably bring even more specialization.

So what will be the real challenge?
Marescaux: All surgeons like new technologies – and the operating room of tomorrow, with all its robotics, will look like the cockpit of an airplane. You will have the robotic system, the 3D visualization, and a lot of screens. You will push the button and the technology will work for you. It will be very easy. But it will be a challenge for surgeons to know everything about radiation protection. Today, surgeons don’t have enough knowledge of radiation. We want to organize courses to help them understand how best to manage the new kind of OR. WeBSurg is a platform for that.

To what extent do robots change operating rooms?
Marescaux: We are still in the prehistory of robotics. At the moment, the robot just improves a surgeon’s abilities. Sure, it is more precise, but that is really just “peanuts.” However, there is another advantage that will change everything: A robot interface can analyze 1,000 signals per second. When you combine the preoperative image and 3D image guidance with the skill of the surgeon, it will be a huge benefit for the patient. 


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The statements by Siemens’ customers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.