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New surgical suite opens at Keck Hospital

From left, USC faculty physicians David Shavelle, Vaughn Starnes and Ray Matthews perform a transcatheter aortic valve implantation in a new hybrid operating room at Keck Hospital of USC. (Photo/Alison Trinidad)

A high-tech operating room that will help improve patient care opened at the Keck Hospital of USC on April 24, making it one of three Southern California hospitals with such a room, often called a “hybrid OR.”

Cardiothoracic surgeon Vaughn Starnes and interventional cardiologist Ray Matthews led three back-to-back heart valve replacements on patients who are part of a U.S. clinical trial testing a nonsurgical, minimally invasive treatment for aortic stenosis.

To complete the experimental procedure, doctors need advanced imaging equipment to replace the diseased valve by threading a narrow catheter through the skin.

Typically, interventional procedures, such as a transcatheter aortic valve implantation (TAVI), are performed in a catheterization lab, which is not equipped for surgery. Imaging instruments usually are not found in ordinary operating rooms since surgeons do not use cameras for open surgical procedures.

The new 1,100-square-foot hybrid room at Keck Hospital is designed for both catheter-based and surgical treatments.

“We would have done this procedure in the cath lab … but the real concern here is when things go bad,” said Matthews, professor of clinical medicine and director of the interventional cardiology program at the Keck School of Medicine of USC. “We want to be in the best position to take care of the patient, and in an operating room like this, we can instantly convert to an open surgical procedure without moving the patient [from the lab to the OR]. It’s a much safer situation for the patient.”

The hybrid room is equipped with multiple high-definition cameras and video monitors that give surgeons better views of the operating field during minimally invasive surgery.

Using technology developed by Karl Storz Endoscopy-America, the audiovisual system links with electronic lab records and hospital information systems and can support live, on-demand teleconferencing. The system allows surgeons to use a laptop device to access live and stored surgical video files through an Internet link. Surgeons also can watch live cases as they are being performed and communicate between ORs.

“This combines the operating room and catheterization laboratory into one, giving us the capability to perform procedures like coronary or aortic graft stenting and open heart surgery at one time,” said Starnes, chair of the Department of Surgery and surgeon-in-chief of the USC hospitals. “This opens a whole new portal for us in terms of the types of therapy we can provide to our patients.”

Mark Cunningham, assistant professor of cardiothoracic surgery at the Keck School, spearheaded the design of the hybrid suite at Keck Hospital, visiting hospitals across the country for the best technology available.

Though the room is targeted to augment cardiovascular therapies, Cunningham said the setup also will benefit general surgery and other specialties, such as neurological and laparoscopic services.

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