Stephan Kanzler and his team from Leopoldina Hospital were first introduced to Luminos Agile on a guided tour through the fluoroscopy production facilities of Siemens in Forchheim, Germany. The visitors were impressed by the system that features the world’s first patient-side controlled fluoroscopy system with a dynamic flat detector and an examination table that can be adjusted to a wide range of heights. Shortly after his facility visit, Prof. Kanzler together with Siemens celebrated the unit’s installation at the Medical Clinic 2 in Schweinfurt as the first installation worldwide.
The new system allows Kanzler and his team to perform endoscopic procedures such as endoscopic retrograde cholangiopancreatography (ERCP), percutaneous interventions, and stent placement with even greater flexibility and speed – in addition to offering their patients new levels of comfort that were not possible before. The shorter procedure times result in more time for the 5,500 inpatients and 3,000 outpatients treated by the hospital unit each year.
Siemens spoke with Dr. Kanzler about his experiences, goals, and hopes.
How does your new system improve your daily work when compared with your old system?
KANZLER: I see improvements both on a user level and on a patient level. Luminos Agile is more user-friendly, easier to operate, and offers greater comfort. For example, the motorized support for moving the system has really proven its value, since you can move the system in any direction without much force. It also monitors errors and tells us what the problem is. For example if the table has not been raised enough this is shown on a small display so you can correct this and continue working. We are working with a product that is new, but already very mature. My colleagues and I are all very pleased.
Have you seen benefits extended to your patients?
KANZLER: Definitely. We often see older, polymorbid patients. The fact that the table can be adjusted in all directions and raised or lowered from very low to very high positions based on the patient’s bed makes it easy to transfer these patients. And we are not the only ones who appreciate that – the patients do, too. Another aspect is the flat detector: In the previous model, the image intensifier above the patient table was very large. The detector in Luminos Agile has been made substantially flatter and slimmer, which is a particular advantage for patients, because the flat detector is less intimidating.
Economically speaking, what benefits have accompanied the system?
KANZLER: Luminos Agile is a practical, flexible system that enables very short changing times between patients. That not only allows us to streamline our workflow, but also offers clear economic benefits, since we can now treat more patients than before in the same amount of time. The sturdier, wider table also lets us manage new groups of patients. I’m thinking especially of our many obese patients. We were limited with our old system, and we simply could not perform examinations on these patients since they were over the system’s weight capacity. We can still move the table to an angle of up to 90 degrees even with very heavy patients. Luminos Agile is also being used by our radiologists for functional upper gastro-intestinal studies.
How would you rate the new system’s image quality?
KANZLER: I have to note that everyone needs to figure out good image quality over time that fits one’s individual needs. Certainly, you can scan at a very high radiation dose, which always gives you good image quality. But you need to find the right balance of low radiation dose and high image quality. With help from Siemens, we have made a couple of extra adjustments so that we now have excellent image resolution at a significantly lower radiation dose. We have been able to reduce the dose by half from previous levels, and yet we still get better image quality. For detailed diagnoses in particular, we need high resolution. And, once the radiation dose has been set, Luminos Agile automatically calibrates the radiation to the patient’s anatomy. The lower radiation exposure is one of the most important aspects to us as doctors as well as to the patient. The table can be adjusted without radiation, since the CAREPOSITION application gives a virtual display of the radiation field. That helps us avoid unnecessary radiation exposure while the table is being positioned. In the long-run, this benefits the patient and us.
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The statements by Siemens' customers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.