Explore Toronto General's new cutting-edge OR

Barry Rubin, a vascular surgeon at Toronto General Hospital, checks in on a scene that will soon seem old school.

A patient lies on the operating table, anaesthetized and oblivious. Crammed elbow-to-elbow around his body is a team of 10 medical professionals. Their eyes are glued to a single television screen showing a live X-ray image of the patient's chest. Those with their backs to the screen crane their necks 180 degrees to watch a vascular surgeon snake a tube up the patient's weakened artery, in what's called a stent graft procedure.

It's an advanced technique but the cluttered room looks subpar – especially when Dr. Rubin heads down the hall to the Cadillac of operating rooms.

“I can't wait," says Dr. Rubin, of the day, later this month, when the new facility is ready for patients.

Like the previous OR, Operating Room 21 is built to treat cardiovascular conditions – only the room is 50 per cent larger and houses superior imaging equipment and surgical tools.

A CT scanner at the head of the operating table allows doctors to diagnose a patient's problem. A remote-controlled angiogram machine, on a pivoting arm, will provide X-ray pictures of blood flowing through vessels and organs. The images will be appear on eight television screens mounted on both sides of the table, so physicians don't have to crane their necks. At 1,000 square feet, the room is spacious and equipped with extra storage.

Operating Room 21 cost $5-million and is one of the largest and most technologically advanced operating rooms in Canada. Facilities such as this are rare in Canada – but they are becoming increasingly important as the field of cardiovascular surgery evolves toward less-invasive procedures guided by X-ray imaging, says Bryce Taylor, chief of surgery for Toronto's University Health Network.

“I think the marriage of imaging and interventions is where everybody's going, no question about it. I'll bet you most major academic centres in North America are at least thinking about this, if they haven't already got one."

So what does this mean for patients?

Dr. Rubin says Operating Room 21 is a “one-stop shop" for care.

He gives an example. Say you come to the emergency room with chest pains. Normally, you'd be taken to an imaging room for X-rays or a CT scan. There are three probable diagnoses: a heart attack, a blood clot in the lungs, or a weakened blood vessel that has burst. Depending on the diagnosis, you are taken to an operating room that's equipped to treat your problem.

But OR 21 is equipped to do all of those things: imaging, diagnosis – and no matter which of the three conditions you have – treatment. The room has all of the necessary imaging and surgical tools to do everything in one place. It's also equipped to deal with unexpected emergencies.

For doctors, the room is a bit like upgrading from a regular house to a mansion. But it's a habitat they have to share.

The room is equipped to do complex chest, heart and vascular procedures, along with other types of surgery that benefit from live imaging. That means various specialties will use the new OR (the hospital's other 19 operating rooms will continue to be used as well).

At the end of the tour, Dr. Rubin bumps into a colleague – a chest surgeon – in the elevator. Dr. Rubin mentions he's been touring the new OR. The other doctor, looking pleased, asks when it's going to open.

“It's hard to keep a room like this a secret," Dr. Rubin says later with a laugh. “They're chomping at the bit to get in here."