AIIMS Delhi has recently installed a state-of-the-art robotic x-ray imaging device that is engineered to capture some of the most comprehensive intra-operative images, optimized for cranio-spinal surgery. Called O-arm Complete Multidimensional Surgical Imaging System, the device, in simple terms, is designed not only to offer the combined functionalities of a C-arm imaging system and a CT scanner right inside the operating room, but also to offer more advanced, automatic multi-planar views to deliver very high quality 3-D volume imaging during surgical procedures.

Professor MC Misra, chief, JPNATC, AIIMS said, "We are delighted to be the first in South East Asia to have such an advanced equipment for cranio-spinal surgery. One of the mandates of JPNA Trauma Centre is to provide the best in healthcare to trauma patients and the O-arm will be a step in that direction."

"Though the device is presently intended for use in spinal surgery procedures, the O-arm imaging system is designed to be extended to other surgical applications involving Computer-assisted-Surgical (CAS) Navigation," said Jayadev Sahu, technical head, Medtronic navigation, south Asia) "With a customized drape for the O-arm and robotic repositioning, including a park mode, the O-arm does not have to be moved in and out of the sterile field as a conventional C-arm does. The O-arm system offers two easy one-time draping options that will guarantee a sterile field is maintained resulting for lower infection rates and highest care for the patient."

The O-arm imaging system also offers certain strategic benefits as well. It provides more imaging-related information to surgeon for complex surgeries; provides state-of-the-art care in the community; empowers Radiology staff by using cutting edge technology, dose reduction; significantly reduces exposure of OR Staff during surgery; and potential to free up diagnostic CT scanners as it offers CT capability in the operating room

High Quality Multiplanar Imaging- Flat Panel detector allows for highest image quality possible in both 2D fluro and 3D acquisition modes. The O-arm's flat panel detector and tube design allow for the following benefits are - no Correction for Distortion- flat panel detector eliminates edge distortion, pin-cushion effect, etc. that is often seen on analog imaging intensifier based c-arm systems and could affect navigation accuracy; Ultra-High Resolution- 2k x 1.5k (3Mega Pixel) flat panel detector delivers the highest Image Quality and resolution available today on a flat panel intraoperative imaging system; this allows the surgeon to visualize anatomy better during surgery resulting in better outcomes; and Higher X-ray Power - The o-arm has the capability to deliver higher power (32kW) than a typical C-arm. This additional power allows for penetration of larger patients, as well as, increased image quality and speed enabling the use of imaging in cases where previously this was not possible.

Large Field of View- 30 x 40 cm digital flat panel detector delivers 3x the area of a 9'' image intensifier (standard C-Arm) and 6x the 3D volume derived from a 9'' image intensifier. Images are then displayed on a 30" flat panel monitor (3 MP). This large field of view allows a surgeon to see four to five vertebral bodies where typically only two to three may be seen using a standard C-arm. This large field of view is very useful in cases such as trauma, orthopaedic and complicated spine cases where the ability to visualize a larger area is required. Fast Scan Time- The O-arm acquires 391 images over 360° 3D scan in 13 seconds and immediately networks these images to the Stealth for Navigation.

3D Image created in operative position- Surgeons are not dependent on pre-operative CT where the patient orientation may vary from surgical position in the OR. The O-arm allows the surgeon to scan the patient in the operative position on the table in the OR. This ensures the most accurate imaging and navigation possible ensuring the best possible surgical outcome for the patient.

Assist in complication avoidance and revisions with post-op 3D scan performed in the OR- The O-arm is the only system available today that provides the surgeon with the ability to perform a post operative 3D spin in the OR prior to closing the patient. This spin ensures the proper placement of hardware prior to closing the patient decreasing or potentially eliminating surgical revisions and complication avoidance. The end result is lower costs to the hospital.

2D and 3D imaging modes- Offers the best of both worlds with the capability to do 2D fluro imaging (as is done today with a conventional C-arm), and 3D "CT Like" imaging for increased confidence and accuracy and visualization for the surgeon.