Key technologies and development trends of integrated operating rooms-EEWORLD

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The integrated operating room effectively integrates the "information islands" inside and outside the operating room by realizing the openness and circulation of information. Medical staff can obtain a large amount of patient-related information conveniently and in real time, and perform more accurate operations with the help of precise navigation systems, thereby improving the efficiency and success rate of operations. A research report shows that even in the United States, the efficiency of traditional operating rooms has always been at a relatively low level, with an average of only 68% of their potential. The integrated operating room can greatly improve the work efficiency of the operating room, shorten the operation time and reduce the number of personnel, which can bring a medium-sized hospital a profit of 4-6 million US dollars per year.

Key technologies of integrated operating room

In recent years, the construction of integrated operating rooms has been widely rolled out in domestic hospitals. However, judging from the current domestic hospitals that have put them into use, many have only completed some of the functions of integrated operating rooms. There are common problems such as the system being incompatible with other brands of medical equipment, not using standard protocols for data storage, low quality of patient imaging data for remote medical communications, and lack of core technical support such as imaging support and surgical navigation.

A complete integrated operating room overall solution should include the following main functions, namely: digital recording, digital integration, digital communication, digital control and digital ergonomics.

Figure 1: Main functions of an integrated operating room

The integrated operating room controls all endoscopic equipment, conventional equipment, operating room panoramic cameras, image management equipment, air conditioning and lighting in the operating room through touch screens and voice control. The system organically integrates surgical equipment so that doctors can conveniently control surgical equipment directly in the sterile area with voice or touch screens, and circulating nurses can also manage up to dozens of devices outside the sterile area with just one touch screen. The integrated operating room platform is also compatible with image-guided surgery technology, robot-assisted surgery technology and remote-controlled surgery technology. In addition, the multimedia communication system can broadcast high-quality images, diagnostic images, and live broadcasts of the operating room during surgery in real time for teaching observation, telemedicine, on-site monitoring of the operating room, and patients' families watching the surgical process.

To achieve the above functions, a series of key technologies need to be overcome. The following lists the eight key technologies for reference by enterprises developing integrated operating rooms. These eight key technologies are: data storage and management technology, network communication and data transmission technology, data conversion and interface technology, image processing and analysis technology, human-computer interaction technology, artificial intelligence technology, surgical planning and optimization technology, and surgical assistance technology.

Humanization and intelligence are the development direction

Some experts believe that based on the integration of relevant information inside and outside the operating room, image navigation systems, surgical simulation systems and robotic systems represent the direction of development of integrated operating rooms.

Image navigation system: Imaging Guided Surgery (IGS) is a feature of the integrated digital operating room and the technical core of the modern operating room. At present, imaging technology is developing rapidly, and technologies such as three-dimensional digital subtraction angiography, computed tomography, intravascular ultrasound, transesophageal three-dimensional echocardiography, and magnetic resonance imaging have successfully entered the operating room. Its real-time, high-definition, intelligent image processing methods and image integration technologies have realized intraoperative imaging, changing the situation in the past where imaging could only be performed before or after surgery. At the same time, IGS has promoted the organic combination of imaging, radiosurgery, and stereotactic technology, and derived a variety of new treatment methods, such as cerebral angiography orientation technology, magnetic resonance orientation technology, and endoscopic stereotactic surgery.

IGS can reconstruct the patient's CT or MRI images in three dimensions, and accurately locate the position of surgical instruments in the surgical field through the intraoperative positioning system. The surgeon can refer to the three-dimensional image displayed on the computer monitor to observe the actual position of the surgical instruments. IGS can also be connected to a surgical microscope or endoscope with navigation function to expand the surgical field of view beyond the microscope and endoscope field of view, so that the surgeon can take into account the important tissue structures around the surgical field while performing the surgical operation in the surgical field.

Figure 2: Integrated operating room at West China Hospital

Surgery simulation system: The surgery simulation system has developed from a general three-dimensional human anatomical model to a personalized model. That is, after inputting the patient's physiological data, the general model can be turned into a model of a specific patient. The whole process of different surgical plans is simulated, and the best surgical plan is selected before it is implemented in the operation. It truly achieves the best surgical effect with the safest possible method and as little damage to normal tissue as possible.

Robotic system: In December 1998, the first Da Vinci surgical robot system was launched. It is currently the best surgical robot system. Today, the Da Vinci surgical robot system has developed to the fourth generation and was approved for use by the U.S. Food and Drug Administration on April 1 this year. The University of Miami Hospital in the United States became the first teaching hospital in the world to use the new generation of the Da Vinci surgical system.

At present, robotic surgery has become the main trend of minimally invasive surgery. At present, more than 600,000 robotic surgeries have been successfully carried out in more than 800 hospitals in 33 countries around the world, covering urology, obstetrics and gynecology, cardiac surgery, thoracic surgery, hepatobiliary surgery, gastrointestinal surgery, otolaryngology and other disciplines. The best surgical plan is formulated from preoperative scanning, preoperative treatment, surgical simulation, and surgical planning, and the robot performs surgical intervention according to the procedure. The whole process of the operation reflects the intelligent development trend of the integrated operating room driven by computer technology, information technology, and automatic control technology.