Hybrid OPERATING ROOM
What is a hybrid operating room?
A hybrid operating room is a theatre that combines imaging and navigation equipment inside the vessels with the aseptic conditions of conventional surgery. Open and endovascular techniques can therefore be applied in the same procedure.
The IGS7 hybrid operating room from GE Healthcare is an asset to the Athens Medical Center and to Greece as a whole. Its modern technology allows vascular surgeons to perform highly specialised procedures for complex vascular conditions. We had the honour of inaugurating this room, named "Prometheus", in 2020. Four years later, the Vascular Surgery Department of the Athens Medical Center leads at a European level in innovation and in treating the whole spectrum of vascular conditions.
Understanding hybrid surgery
The hybrid operating room is the space that combines two functions. It has imaging and navigation equipment for working inside the vessels, like a catheterisation laboratory. At the same time it offers the best possible aseptic conditions, ISO 5 and above, for open surgical procedures.
The main advantage is its aseptic environment, which is not achieved in any other catheterisation laboratory. Multiple grafts are placed in the human body: stents, endografts, balloons and wires. In the large vessels, and particularly the aorta, this must always take place under the best possible aseptic conditions. The possibility of open surgery under such conditions is decisive in an emergency, such as bleeding or rupture of a vessel. This hybrid operating room allows the surgeon to move the angiography unit away from the surgical field immediately. The urgent intervention is therefore made easier and asepsis is fully maintained.
Theodosios Bisdas, Associate Professor of Vascular Surgery and Director of the 3rd Vascular Surgery Department of the Athens Medical Center, performs the full range of endovascular and hybrid vascular surgery procedures in the IGS7 hybrid operating room (GE Healthcare) of the Athens Medical Center.
The IGS7 software makes use of artificial intelligence and robotic assistance in navigation inside the vessels. Compared with conventional surgery, robotic guidance offers greater precision in handling the catheters and reduces radiation for both the patient and the surgical team. Prof. Theodosios Bisdas presented the subject at the LINC conference in Leipzig in 2025.
Endovascular access is gained with a puncture of 2 to 8 millimetres, without a surgical incision. The hybrid operating room has been in use since 2020 and has aseptic conditions of ISO 5 and above, the same as a conventional operating theatre.
The role of the vascular surgeon in the hybrid operating room
This particular Hybrid operating room Three-dimensional imaging on the operating table is of great importance. In a complication, or when the anatomy is complex, the surgeon can see the vessels in real time. The plan can then be adjusted during the procedure.
Vascular surgical procedures in the hybrid operating room
The vascular surgeons perform the entire spectrum of complex vascular surgical conditions in the Hybrid operating room of the Athens Medical Center. These conditions include the minimally invasive repair of:
- aortic arch and thoracoabdominal aneurysm
- carotid stenoses (carotid disease)
- aneurysms of the splanchnic vessels (splenic, renal artery)
- treatment of pulmonary embolism and deep venous thrombosis
- opening of the peripheral vessels in patients with peripheral arterial disease or diabetic foot
- treatment of erectile dysfunction
- special treatments for arteriovenous malformations and hemangiomas
- minimally invasive creation of fistula for haemodialysis patients.
