gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Double-room CT scanner with sliding gantry for intraoperative imaging in neurosurgical interventions

Meeting Abstract

  • Markus Lenski - Neurochirurgische Klinik und Poliklinik, Klinikum der LMU,Campus Großhadern, München, Deutschland
  • Johann Hofereiter - Neurochirurgische Klinik und Poliklinik, Klinikum der LMU,Campus Großhadern, München, Deutschland
  • Nicole Terpolilli - Neurochirurgische Klinik und Poliklinik, Klinikum der LMU,Campus Großhadern, München, Deutschland
  • Stefan Zausinger - Neurochirurgische Klinik und Poliklinik, Klinikum der LMU,Campus Großhadern, München, Deutschland
  • Jörg-Christian Tonn - Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Friedrich-Wilhelm Kreth - Neurochirurgische Klinik und Poliklinik, Klinikum der LMU,Campus Großhadern, München, Deutschland
  • Christian Schichor - Neurochirurgische Klinik und Poliklinik, Klinikum der LMU,Campus Großhadern, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.06.04

doi: 10.3205/17dgnc212, urn:nbn:de:0183-17dgnc2129

Published: June 9, 2017

© 2017 Lenski et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: The growing demand for short turnaround time and cost effectiveness in operating room management also affects intraoperative imaging and the management of its complex and expensive devices. Aim of this study was to examine our experience with a series of patients, treated with aid of a new double room CT scanner (DR-CT), which was used by several operative disciplines simultaneously.

Methods: A multislice CT scanner was installed in between two operating rooms, connected to a neuronavigation system with direct transfer of imaging data. Several neurosurgical teams (skull base, spine, vascular neurosurgery, stereotactic surgery) used the DR-CT simultaneously. In addition it was used by the Department of Surgery. For image acquisition, the sliding gantry moved into one operating room, whereas a moving wall was closed to the other one. Image quality, workflow, utilization rate, intraoperative CT (iCT) related complications and surgical procedures were analyzed retrospectively. Non-parametric data were compared by using the Mann-Whitney-U-Test.

Results: Intraoperative CT-imaging in the DR-CT was undertaken 347 times between 01/09/2014 and 31/07/2016. Neurosurgical procedures included 23 skull base surgeries, 38 spine fusions, 8 vascular surgeries and 265 stereotactic procedures since 01/02/16. The iCT was used 11 times by the Department of Traumatology and once by the Department of Thoracic Surgery. Workflow analysis showed similar patient turnover times with (n=69) and without iCT (n=333) (Operating room-cutting time: 41 ± 13 minutes vs 33 ± 9 minutes, p=0.53; suture-cutting time: 95 ± 18 minutes vs 100 ± 44 minutes, p= 0.97; time from the end of surgical measures to release of the next patient 25 ±16 minutes vs 40 ±44 minutes, p= 0.43). The hygienic cleaning of the gantry took 27±11 seconds (n=43). The iCT utilization rate increased from 2.6±1.4 per month during the introduction phase (09/14-06/15) to 24.8±25.3 per month during the routine use phase since 07/15, but did not differ significantly (p= 0.09). There were no iCT related complications and no operative procedure was hampered by ongoing iCT imaging in the neighboring OR.

Conclusion: The concept of DR-CT in two operating rooms facilitates a broader and multidisciplinary use, increases the utilization rate and does not prolong patient turnover times. Substantial changes of the surgical workflow or surgical instruments are not necessary. The DR-CT may facilitate the availability of iCT for stereotactic procedures, intraoperative resection control, perfusion imaging and angiography, and implant control.