Intraoperative Diagnostics

The future of intraoperative diagnostics starts at Munich’s Grosshadern University Hospital in Germany. The pioneers are: Siemens, BrainLab and TRUMPF Medical Systems Systeme.

The surgical table moves almost silently, remotely controlled by the surgeon’s hands: Move everything a bit higher, the head a little lower, tilt a bit more. Finally, the patient is in the desired position, everything is ready — not for the OR, though, but for a little “crash test” to be done beforehand with the CT tube waiting in the background …

We are in the newly opened research OR in Grosshadern University Hospital in Germany. A normal, medium-sized OR that looks just like any other — so it seems. And yet it is equipped with a few technical special features that make it unique in the world. First of all, a movable, rail-mounted sliding gantry has been installed — a high-resolution spiral-CT made by Siemens with an 82-cm diameter tube. Secondly, there is a new navigational system developed by BrainLab that communicates directly with the CT for the intraoperative updating of the image data. And last but not least, a JUPITER surgical table made by TRUMPF Medical Systems. Since its surgical table board is made of carbon, X-rays can pass through it. Its adapters and the head-strapping device do not show up in the X-rays as interference artifacts. After all, these three products work together precisely to ensure patient-friendly, intraoperative diagnostics. In Grosshadern they are made fit for that purpose.

With this, we are back to the “crash test” mentioned above. While the CT is moved along its rails, Dr. Eberhard Uhl, managing chief physician of the Neurosurgical Department at the Grosshadern University Hospital, explains why the test is essential: “The good part of our new system is that we neither have to transfer the patient to another bed nor even have to change his or her lying position in order to do the intraoperative scan. To accomplish this, we merely have to shift the surgical table horizontally and vertically so the sliding gantry can glide over the table, the support and the aseptically covered patient without bumping into anything. Thus, we test the correct position before surgery.” Once found, it is saved using the touch screen in the wall of the surgical table and can later be automatically recalled. If needed, several OR and scanning positions can also be saved. Then, surgery can begin.