Graham Maritz, CEO Healthcare Sector Siemens Southern Africa, says the Artis zeego offers surgeons significant advantages when performing procedures that normally require open surgery.

“An increasing number of procedures can now be performed with minimally invasive surgery, either by working through a blood vessel or with very small incisions,” he says. “These interventions, which require improved imaging technology to help navigate the procedure, generally result in reduced morbidity rates and faster recovery for patients when compared to open surgery.” Recent developments in surgical techniques such as endovascular aortic repair or trans-catheter valve replacement, promise far better therapeutic possibilities by combining and interventional procedures. Now patients that had previously been considered too old or too sick for open surgery can be treated.

Maritz says the ideal environment for these procedures is the hybrid operating theatre, an integrated operating room with high-end imaging capabilities for interventions.One of the strongest points for a hybrid room is that the patient does not need to be transferred to a dedicated room with an imaging system in order to perform an intervention but he can be treated in the same room, on the same table.

With the Artis zeego, an angiography system based on robotic technology, Siemens delivers the most advanced imaging for the hybrid lab. The surgeon has the choice between two fully integrated table systems. First, an endovascular table with a floating table top. Second, a conventional OR table system with two different exchangeable table tops – a radiolucent one-piece carbon table top and a breakable table top.

“As a floor-mounted robotic angiography system, the Artis zeego allows for previously unknown degrees of freedom and flexibility as it is the first system equipped with a multi-axis robotic arm”, he says. “Conventional C-arm systems restrict the position of the patient isocentre and limit the amount of coverage for 3-D acquisitions”. The isocentre is the area where anatomy being imaged must be positioned for the best image quality. This means the patient always has to be right in the middle between tube and detector. Changing the table height in conventional systems brings the patient out of the isocentre and consequently affects image quality. With cardiac and vascular operations being highly complex and time consuming, ergonomics for the operating team require a variable table height. Consequently, the best image quality can only be guaranteed by a variable isocentre, as uniquely realized in the Artis zeego system. Now, clinical needs and comfort for the surgeon rather than technical limitations are in the focus during a procedure.

The unique positioning capabilities of the Artis zeego allow C-arm positioning from the side. This way the head side can be kept free and interference with anesthesia can be avoided.

“Furthermore, Siemens offers syngo DynaCT, a special imaging modality producing CT-like images from a series of images and projections, acquired as the x-ray tube and detector rotate around the patient. These can then be reconstructed to form 3-D visualisations,” Maritz says. “To date, the CT images obtained with conventional angiography systems have a small field of view - circular diameter of 24 centimetres - which is insufficient to image for example the complete thoracic aorta. However, the Artis zeego’s unique  option ‘landscape DynaCT’ makes it possible to almost double the field of view - elliptical 24 × 47 centimetres - by performing two rotations in rapid succession. This allows imaging e.g. both femoral arteries at a time.”

Furthermore, Siemens’ unique software syngo iPilot provides 3-D roadmapping, in which previously obtained 3-D images (e.g. acquired with syngo DynaCT) are superimposed over live fluoroscopy images. This leaves the clinician free to concentrate on the intervention. As a result, complicated interventional procedures become less time-consuming, more accurate and practical to perform, and will result in improved patient outcomes.

“Simply put, Zeego brings surgery and industry together,” he concludes.

The Siemens Healthcare Sector

The Siemens Healthcare Sector is one of the world’s largest suppliers to the healthcare industry. The company is a renowned medical solutions provider with core competence and innovative strength in diagnostic and therapeutic technologies as well as in knowledge engineering, including information technology and system integration. With its laboratory diagnostics acquisitions, Siemens Healthcare is the first integrated healthcare company, bringing together imaging and lab diagnostics, therapy, and healthcare information technology solutions, supplemented by consulting and support services. Siemens Healthcare delivers solutions across the entire continuum of care – from prevention and early detection, to diagnosis, therapy and care. Additionally, Siemens Healthcare is the global market leader in innovative hearing instruments. The company employs more than 49,000 people worldwide and operates in 130 countries. In the fiscal year 2007 (Sept. 30), Siemens Healthcare reported sales of €9.85 billion, orders of €10.27 billion, and group profit of €1.32 billion. Further information can be found by visiting www.siemens.com/healthcare.

About Siemens Southern Africa:

Siemens has had a presence in South Africa since 1860 when the company installed the first telegraph line linking Cape Town and Simon’s Town. Today, Siemens offers a balanced portfolio of technologies focusing on the Industry, Energy and Healthcare sectors, together with the cross-sector business of Siemens IT Solutions and Services. The unique ability to offer horizontal, customised, end-to-end technology solutions enables Siemens to keep its customers one-step ahead. As a committed corporate citizen, Siemens has active corporate social investment programmes as well as a comprehensive approach to local content, manpower development, skills and training. Further information is available on the Internet at www.siemens.co.za