Durchleuchtung mit Kryptoskop und dem transportablen Röntgenapparat Nanos, 1932

X-rays in the operating room

Reinforcements for surgeons

Stefan Dirnberger
Published on March 1, 2022
<p>The shape of the C-arm was so suited to applications in the OR that even cutting-edge devices, such as the ARTIS pheno system from Siemens Healthineers, still use this construction today. In terms of technology, however, Siemens Healthineers is continuing to break new ground with ARTIS pheno – at the time of its introduction the only robotics-equipped C-arm system on the market. It recognizes the position of the tabletop at all times and aligns itself to the tabletop with every movement. Thanks to memory positions, the system can move the C-arm out of the operating area quickly if necessary, giving the surgeon and the operating team free access to the patient. The C-arm can then be moved back to exactly the same position again for further imaging. This means results can be checked directly, even while the operation is still in progress.<br><br>Accurate and detailed imaging not only helps physicians with their work, but also benefits the patient directly. It is a vital part of minimally invasive surgery – that is, surgery that has the least possible impact on the patient. For a long time, this type of procedure was used primarily in cardiovascular surgery and neurosurgery – for example, to insert “stents” (supports used to treat the narrowing of blood vessels). Modern hybrid ORs equipped with high-tech equipment, such as ARTIS pheno systems or SOMATOM computed tomography (CT) scanners, are helping other disciplines – such as orthopedics and trauma surgery – to perform more and more minimally invasive operations as well. This type of intervention is gentler than open surgery and, as such, is particularly important for treating older patients or patients with preexisting conditions. Moreover, minimally invasive surgery can significantly shorten the recovery period and the length of hospital stay. For instance, pelvic fracture patients who receive a minimally invasive screw fixation procedure can walk with full weight-bearing just one day after the operation. Nowadays, it’s impossible to imagine medical imaging without software solutions. For example, syngo DynaCT captures hundreds of individual images and takes just a few seconds to convert them into 3D images that resemble those from CT scanners. Particularly important information from the generated images can be superimposed on fluoroscopic images during the examination to allow physicians to navigate the procedure even more precisely.</p>
Das ARTIS pheno beim Einsatz im OP, 2016
<p>Even computed tomography (CT) itself is now used directly in the operating room. In these systems, the gantry slides over the patient on rails without requiring them to be moved or repositioned for the scan. When the system is not in use, it can slide back to its parking position. The rails themselves are set into the floor so that they do not present an obstacle for equipment trolleys or beds.<br><br>Electronic image intensification, robot-assisted C-arm systems, and CT scanners – in the early days of X-ray technology, surgeons presumably couldn’t even have imagined the benefits of these accomplishments. However, it is thanks to achievements such as these that X-ray imaging is no longer simply a useful tool when preparing for an operation, but now also plays a key role in the surgeon’s work inside the OR.</p>
Die SOMATO CT Sliding Gantry Systeme stehen auf bis zu 12 Meter langen Schienen, durch die sie je nach Bedarf an den Patienten herangefahren werden können, 2017

Stefan Dirnberger
Stefan Dirnberger
By Stefan Dirnberger

Expert for History Communication and Historian at the Siemens Healthineers Historical Institute