This hybrid operating room combines interventional radiology and neurosurgery with a Siemens bi-plane angiography system at its core. See how the staffing and procedures are set up to use the room for the different modalities. This project was delivered using 3D building information modeling (BIM) which is a process that parallels the work being done in the room itself. We use sophisticated 3D imaging to evaluate the building systems and then surgically remove and replace systems.

1. NEURO-INTERVENTIONAL HYBRID ROOM 9
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2. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
MOTIVATION FOR HYBRID ORs
Convergence of Technology and Patient Needs
Consolidation of interventional and surgical environments
Growth of minimally invasive treatment vs. surgery
Boundaries disappearing between disciplines
Increasing use of fixed imaging systems for endovascular
procedures
Endovascular and open procedures in same room without moving
patient
Limited Space
Room used for several services or procedures
Provide maximum utilization of space
Reimbursement
Room flexibility allows full utilization & continual revenue
Increased flexibility = fewer complications = better outcomes =
lower cost
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3. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
HYBRID ROOM PROCEDURES
Interventional Interventional
Vascular Surgeon Cardiac Surgeon Cardiologist Cardiologist Neurosurgeon
(Adult) (Peds)
Common Abdominal aortic Coronary artery Diagnostic caths Hypoplastic left Aneurysm coiling
Procedures aneurysm (AAA) bypass graft Coronary heart syndrome Intracranial
Thoracic aortic (CABG) stenting Heart biopsy stenting
aneurysm (TAA) Aortic valve PTCA Diagnostic cath Carotid stenting
Carotid stenting replacement Peripheral PTA ASD Intra-arterial TPA
Peripheral PTA Mitral valve Peripheral VSD
Peripheral stenting repair/replacemen stenting PFO
Peripheral artery t Atherectomy PDA
bypass Ventricular assist
device
implantation
Heart transplant
Procedure AAA MIDCAB/stent Peripheral Structural heart Aneurysm coiling
well suited for TAA Valve/stent stenting Hybrid Stage I
Hybrid Room Peripheral stenting Percutaneous Sent/MIDCAB
valves Stent/valve
Source: Hospital of the Future, The Advisory Board Company Percutaneous
valves
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4. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
NEURO-INTERVENTIONAL ROOM 9 PROCEDURES
Interventional Interventional
Vascular Surgeon Cardiac Surgeon Cardiologist Cardiologist Neurosurgeon
(Adult) (Peds)
Common Abdominal aortic Coronary artery Diagnostic caths Hypoplastic left Aneurysm coiling
Procedures aneurysm (AAA) bypass graft Coronary heart syndrome Intracranial
Thoracic aortic (CABG) stenting Heart biopsy stenting
aneurysm (TAA) Aortic valve PTCA Diagnostic cath Carotid stenting
Carotid stenting replacement Peripheral PTA ASD Intra-arterial TPA
Peripheral PTA Mitral valve Peripheral VSD
Peripheral stenting repair/replacemen stenting PFO
Peripheral artery t Atherectomy PDA
bypass Ventricular assist
device
implantation
Heart transplant
Procedure AAA MIDCAB/stent Peripheral Structural heart Aneurysm coiling
well suited for TAA Valve/stent stenting Hybrid Stage I
Hybrid Room Peripheral stenting Percutaneous Sent/MIDCAB
valves Stent/valve
Source: Hospital of the Future, The Advisory Board Company Percutaneous
valves
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5. 3D PROCEDURE & EQUIPMENT PLANNING PROCESS

6. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
TYPICAL VASCULAR PROCEDURE
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7. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
TYPICAL VASCULAR PROCEDURE
S Surgeon
AS Assisting Surgeon
INJ US
PA PA PA PA/SA
AN Anesthesiologist
AS S
INJ Contrast Injector
US Ultrasound (IVUS)
AN AM
EEG Physiologic Monitoring
AC
AM Anesthesia Machine
EEG
AC Anesthesia Cart
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8. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
NEUROSURGERY ANESTHESIA LOCATION
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9. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
NEUROSURGERY ANESTHESIA LOCATION
S Surgeon
AC
AS Assisting Surgeon
AN
AM
INJ NAV PA PA/SA
PA AN Anesthesiologist
PA Contrast Injector
INJ
S MIC Microscope
MIC
NAV Navigation
PCW
MAS Mobile Aspirator
PCW Patient Cooler/Warmer
EEG Anesthesia Machine
AM
AC Anesthesia Cart
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10. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
TYPICAL NEUROSURGERY PROCEDURE
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11. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
TYPICAL NEUROSURGERY PROCEDURE
S Surgeon
AC
AS Assisting Surgeon
AN
AM
PA PA/SA
INJ
AN Anesthesiologist
PCW NAV
INJ Contrast Injector
PA PA
MIC Microscope
MIC S NAV Navigation
MAS Mobile Aspirator
PCW Patient Cooler/Warmer
EEG Anesthesia Machine
AM
AC Anesthesia Cart
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12. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
PHYSICAL MOCKUP: SURGICAL LIGHTS
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13. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
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14. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
VIRTUAL EQUIPMENT SIMULATION
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15. 3D CONSTRUCTION PLANNING

16. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
3D MEDICAL IMAGING VS 3D CONSTRUCTION IMAGING
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17. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
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18. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
3D LASER SCAN
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19. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
3D CONSTRUCTION MODEL
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20. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
FABRICATION FROM 3D MODEL
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21. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
ABOVE CEILING UTILITIES
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22. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
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23. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
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24. Stanford Hospitals & Clinics Neuro-Interventional Hybrid Room 9
OUTCOMES
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