Mediclinic Cape Gate’s new Hybrid Vascular Theatre offers multiple patient benefits
Posted on 2 June 2021
With the recent upgrades to the facility, Mediclinic Cape Gate is now able to offer the services of a hybrid vascular theatre for complex surgical cases.
This theatre offers an advanced procedural space that combines a traditional operating room with an image guided interventional suite, allowing for highly complex, advanced image-guided surgical procedures. This comes with the benefit to the community of having the convenience of such technology at their door step.
Dr Pierre Mouton, our vascular surgeon at Mediclinic Cape Gate, expressed his enthusiasm as he described the number of intricate procedures that can now be performed. These include endovascular aneurysm repair, revascularisation of occluded vessels in the limbs with balloon angioplasty and/or stenting, intestine, kidney, and carotid artery (main neck artery to the brain) procedures. This technology will also assist with the removal of thrombi (clots) or emboli from blocked arteries or veins (a procedure known as thrombectomy). The theatre will also allow embolisation (stopping) of bleeding vessels, tumors and vascular malformations which in turn prevents large amounts of blood loss and shock.
The enormous benefit of this theatre is that if needed, minimally invasive surgery can be easily converted to an open procedure as all the necessary capabilities are available.
What is a hybrid vascular theatre?
A hybrid vascular operating theatre is a standard surgical operating theatre which has been equipped with technically advanced medical imaging devices normally found in interventional radiology suites or cardiac catheter laboratories. The advantage of this high-tech operating theatre with high-end imaging is that it allows multidisciplinary teams such as vascular surgeons and interventional radiologists to perform highly complex surgical procedures assisted by skilled nurses.
The newly placed technically advanced imaging equipment includes a robotic C-arm imaging device. This robotic C-arm allows free range of movement over or under any part of the patient’s body allowing the acquisition of 3D ultra-high-definition images. These images facilitate pre-procedural, intra-operative decisions and guidance aiding immediate response and reaction to interventional or operative complexities by the doctor.
Not only does the technically advanced robotic C-arm provide high-definition images, it also reduces patient radiation exposure as well as the quantity of contrast administered to the patient, thus protecting renal function. In turn, procedure time and anaesthetic duration are reduced.
Dr Mouton shares his appreciation of this addition to Mediclinic Cape Gate after a recent surgical procedure, “Saving our most recent patient with a complicated ruptured aneurysm, without this theatre and without this image quality and guidance would have been impossible.”
How does this affect the patient’s admission and recovery?
Dr Mouton explains that typically the procedures listed above are extremely complex in a traditional theatre in comparison to the hybrid vascular theatre. A conventional open aortic aneurysm repair would generally entail a large incision with complex dissection as well as long ICU stay of, on average, 5 days, followed by a further 5 days in hospital. The patient would typically only return to normal activity after about 4-6 weeks. However, with an endovascular (closed) repair of an aneurysm in a hybrid vascular theatre, the procedure would only require 2 small groin incisions with the placement of a stent-graft in the aortic aneurysm (dilated area of the aorta). There would be a 2 day stay in ICU and another 1-2 days in the ward, with the patient being back to normal activity within 2 weeks.
If for any reason there is a need to convert to open surgery, this conversion can be done immediately and effortlessly as the hybrid operating theatre has the required capabilities. Complex aneurysms may be managed with a combination of open surgery and the assistance of image guided interventions. Real-time completion imaging is performed giving the surgeon the opportunity to evaluate the accuracy and functionality of the procedure.
The benefits described above would also apply when the revascularisation (restoration of the perfusion of blood) of a limb is done endovascularly. “Intricate complex procedures that require both open surgery and endovascular management can be performed simultaneously in a hybrid vascular theatre,” explains Dr Mouton.
How does the patient benefit from this?
- Reduced radiation and contrast exposure
- Shorter duration of hospital stay
- Shorter recovery time.
- Quicker healing time due to smaller wounds
- Return to previous functionality sooner
- Procedures may be done under local anaesthetic, therefore high risk patients could still qualify for treatment where they would otherwise be excluded
- Reduction in post-operative complications
- Reduction in the need for some patients to undergo multiple procedures
- A complicated minimally invasive procedure can be converted immediately to an open procedure timelessly and effortlessly
This new hybrid vascular theatre provides exciting opportunities that benefit all patients and enables Mediclinic Cape Gate to offer the community the best, most advanced treatments possible.
We look forward to many more successful surgeries.