Abstract
Background
Hybrid operating rooms are used in different fields of surgery. In orthopedic surgery, the possibility of a 3D scan of difficult anatomical regions (spine, pelvis) showed promising results not only in navigated screw placement. The associated exposure to radiation raises questions regarding potential risks for the operating room personal and the patient. The present study focuses on scatter radiation during 3D scans in a hybrid operating room, the adjacent rooms, and methods to reduce radiation exposure.
Material and Methods
\(\hbox {RaySafe}^{\mathrm{TM}}\) i2 dosimeters were used to measure scatter radiation during 3D scans of different anatomical regions in different distances and heights in a hybrid operating room. The 3D scans were performed with a floor-based flat-panel robotic C-arm with 3D scan capability (Artis Zeego, Siemens; Germany). The 3D scans were performed using a human cadaver. The 3D scans were performed using a standard and a dose reduction protocol (DRP).
Results
The highest scatter radiation was measured during 3D scans of the pelvis on the side of the surgical assistant (39.5 Sv in height of 1 m) compared to the side of the main surgeon (23 Sv in height of 1 m). Scatter radiation was less on the position of the scrub nurse (6.8 Sv in height of 1 m) and during 3D scans of the other anatomical regions. The radiation dosage was about 66% less with the DRP. Low values of scatter radiation were measured behind a radiation protection wall and with open doors in the adjacent rooms.
Conclusion
While performing a scan scatter radiation was measured everywhere in the operating room especially during 3D scans of the pelvic girdle. Therefore, settings with lower dosage should be used whenever possible. Personnel should stand behind a radiation safety wall or leave the operating room and close the doors. For this study, six behavioral rules to avoid radiation in a hybrid operating room were established.
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15 June 2018
The original version of this article unfortunately contained a mistake. In abstract, results section should read.
17 February 2022
A Correction to this paper has been published: https://doi.org/10.1007/s11548-022-02569-4
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Funding
This work was partially funded by the AO Trauma Foundation through a Grant S-13-128K.
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The authors declare that there is no conflict of interest. No company had influence in the collection of data or contributed to or had influence on the conception, design, analysis and writing of the study. No further funding was received
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The study was approved by the local and has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki
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Schuetze, K., Kraus, M., Eickhoff, A. et al. Radiation exposure for intraoperative 3D scans in a hybrid operating room: how to reduce radiation exposure for the surgical team. Int J CARS 13, 1291–1300 (2018). https://doi.org/10.1007/s11548-018-1747-1
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DOI: https://doi.org/10.1007/s11548-018-1747-1