Hybrid Operative Room for Vascular Neurosurgery: Applications, Limits, and Perspectives.

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Surgery

Background:

• Hybrid operating rooms (HORs) merge microsurgical theaters with advanced imaging like intraoperative digital subtraction angiography (DSA).
• Initially for vascular surgery, HORs are increasingly adopted by neurosurgical teams globally.
• The University Hospital of Dijon Bourgogne recently launched a HOR, detailing their experience.

Purpose of the Study:

• To define specific neurovascular conditions benefiting from HORs.
• To review the literature on HOR applications in neurosurgery.
• To assess the advantages of a multidisciplinary environment for complex cases.

Main Methods:

• Narrative literature review.
• Description of the implementation of a HOR.
• Analysis of neurosurgical cases managed within the HOR.

Main Results:

• HORs enable immediate intraoperative assessment and conversion between microsurgical and endovascular techniques.
• This integrated approach facilitates immediate surgical result evaluation without patient transfer.
• High cure rates for neurovascular malformations were observed, with minimized morbidity and mortality.

Conclusions:

• HORs offer a unique, demanding, multidisciplinary environment for vascular neurosurgery.
• The combination of diagnostic, interventional endovascular, and microsurgical capabilities is highly effective.
• HORs significantly improve outcomes for complex neurovascular malformations.