What monitor features are essential in hybrid operating rooms?

You are trying to simultaneously view a live fluoroscopy image and an endoscopic video feed, but your monitors are not synchronized. This forces you to constantly look back and forth, disrupting your focus during a complex procedure.

Essential features for hybrid operating room monitors include multi-modality support for simultaneous image display, ultra-low latency for real-time feedback, high brightness and contrast to overcome ambient lighting, and flexible input connectivity (SDI, HDMI, DP) to integrate diverse imaging systems seamlessly.

The hybrid operating room¹ represents a significant evolution in surgical care, combining a fully equipped surgical suite with advanced medical imaging systems like fixed C-arms, CT scanners, or MRI machines. This integration allows for both open and minimally invasive procedures² to be performed in the same space, often on the same patient in a single session. At the heart of this complex environment is the surgical monitor³, which serves as the central visual hub for the entire surgical team. The demands placed on these displays are far greater than in a standard OR. They must be able to process and present information from multiple, disparate sources with absolute clarity and precision. Selecting the right monitor is therefore not a matter of simple preference but a critical decision that directly impacts procedural efficiency, clinical decision-making, and patient safety. In this article, we will examine the specific features that a monitor must possess to function effectively in the demanding environment of a modern hybrid OR.

Why is multi-modality support crucial in hybrid OR monitors?

Your surgical team struggles to correlate a static MRI with a live C-arm image on separate screens. This disjointed view slows down decision-making and increases the cognitive load on the surgeon during a critical intervention.

Multi-modality support is crucial because it allows a single monitor to display multiple imaging sources—such as fluoroscopy, endoscopy, ultrasound, and patient vitals—simultaneously. This consolidated view improves workflow, enhances anatomical correlation, and enables faster, more informed clinical decisions without cluttering the operating room with multiple displays.

A hybrid operating room, by its very nature, generates a vast amount of visual data from different sources. During a single procedure, a surgeon might need to reference live fluoroscopy, pre-operative CT scans, real-time intravascular ultrasound (IVUS), and hemodynamic data simultaneously. Without a monitor capable of managing these inputs, the surgical team is forced to use multiple separate displays, creating a cluttered and inefficient workspace. This is where multi-modality support⁴ becomes essential. Features like Picture-in-Picture (PiP)⁵, Picture-by-Picture (PbP), and quad-view layouts allow a single large-format display to present all necessary information in a cohesive and organized manner. This capability is more than a convenience; it is a critical safety feature. For example, displaying a live fluoroscopic image alongside a pre-operative 3D roadmap allows the surgeon to precisely navigate catheters and guidewires with enhanced confidence. Our MS430PC 4K monitor is designed specifically for this purpose, offering customizable layouts that allow surgeons to arrange up to four different video sources on one screen. This integrated view eliminates the need for the surgeon to constantly shift their gaze and mentally fuse information from different monitors, reducing cognitive load and the potential for error.

Common Imaging Modalities and Signal Types in Hybrid ORs

How important is ultra-low latency for image display during hybrid procedures?

During a delicate stent placement, you notice a slight but perceptible lag between your hand movements and the guidewire’s movement on the screen. This delay creates uncertainty and forces you to work more slowly, increasing procedure time.

Ultra-low latency is critically important because it ensures the image on the screen is perfectly synchronized with the surgeon’s real-time actions. Any delay, or latency, in image-guided procedures can compromise hand-eye coordination, leading to inaccurate device placement, vessel damage, and increased risk to the patient.

In the context of image-guided surgery⁶, latency refers to the time delay between when an image is captured by the imaging device and when it is displayed on the monitor. While a delay of a few milliseconds may seem insignificant, it can have profound consequences during procedures that require sub-millimeter precision. In endovascular procedures like aneurysm coiling or stent graft deployment, the surgeon relies entirely on the monitor for visual feedback. A high-latency display⁷ creates a disconnect between the surgeon’s actions and the visual confirmation of those actions, which can lead to overcorrection, vessel perforation, or improper implant deployment. The acceptable threshold for latency in these applications is extremely low; delays greater than 30-40 milliseconds can become perceptible and disruptive to a surgeon’s workflow. We design our surgical monitors to minimize this delay through every stage of the signal processing chain. The MS321PC surgical monitor, for instance, features an advanced image processing engine that achieves near-zero latency, ensuring that the visual information presented to the surgeon is a true real-time representation of the operative field. This is not a luxury feature but a fundamental safety requirement for any hybrid OR where image-guided interventions are performed.

Impact of Latency on Surgical Precision

Do hybrid ORs demand higher brightness and contrast than standard ORs?

Intense surgical lights are aimed directly at the operative field, creating harsh reflections on your monitor. The glare washes out the grayscale details on the fluoroscopy image, making it difficult to visualize guide wires and vessel walls.

Yes, hybrid ORs demand significantly higher brightness and contrast. The complex lighting environment, which includes powerful surgical spotlights and ambient room light, requires monitors with high luminance (typically >700 cd/m²) and a high contrast ratio to ensure images remain clear, detailed, and free from glare.

The visual environment in a hybrid operating room is one of the most challenging in any medical setting. Unlike a darkened radiology reading room, a hybrid OR is intensely illuminated by multiple powerful surgical lights necessary for open procedures. This high ambient light can easily wash out images on a standard monitor, reducing perceived contrast and obscuring critical details. Monitors designed for this environment must have sufficient brightness, or luminance, to cut through the ambient glare. While a standard office monitor might have a brightness of 250-300 cd/m² (nits), a hybrid OR monitor⁸ often requires levels exceeding 700 cd/m². Furthermore, these displays must maintain a high contrast ratio to ensure that both subtle grayscale variations in radiological images and vibrant colors in endoscopic video are clearly visible. The MS275P 4K surgical monitor features a peak brightness of 800 cd/m²⁹ combined with a high-contrast panel and an advanced anti-reflection coating. This combination ensures that surgeons can clearly see fine anatomical structures, such as the edge of a stent or the subtle texture of tissue, even when the monitor is positioned near the main surgical lights. The ability to accurately display the full range of grayscale values is also critical, which is why our monitors include a DICOM Part 14 compliant mode¹⁰ to ensure perceptually linear display of medical images like fluoroscopy or CT scans.

What role does flexible input connectivity play in hybrid surgical setups?

You are trying to connect a new ultrasound machine to the main surgical boom monitor, but it lacks the required DisplayPort input. This forces your team to use a cumbersome and potentially unreliable signal adapter, interrupting the surgical workflow.

Flexible input connectivity is a foundational requirement, enabling the monitor to serve as a central hub for all imaging equipment. A comprehensive set of ports (3G-SDI, DisplayPort, HDMI, DVI) allows direct, reliable connection from diverse sources like C-arms, endoscopes, and navigation systems without workflow-disrupting adapters.

A hybrid operating room¹¹ is defined by the integration of multiple complex imaging devices. A fixed C-arm, a mobile ultrasound unit, an endoscopy tower, a surgical microscope, and a computer running navigation software may all need to be displayed during a single procedure. Each of these devices may output its signal using a different connection standard. For instance, fluoroscopy systems typically use 3G-SDI for its long-distance signal integrity, while endoscopy towers often use HDMI, and computer-based systems may use DisplayPort. A monitor with a limited set of inputs would necessitate a web of adapters and converters, which are common points of failure and can introduce signal degradation or latency. Therefore, a true hybrid OR monitor must feature a comprehensive array of input options¹² to accommodate every device in the room. The MS550P large-format 4K display is equipped with a full suite of modern and legacy inputs, including multiple 3G-SDI, HDMI 2.0, and DisplayPort 1.2 connections. This flexibility allows for direct plug-and-play connection from virtually any medical imaging device, simplifying OR setup and improving reliability. This robust connectivity ensures that as technology evolves and new equipment is introduced, the monitor remains a future-proof central component of the hybrid OR’s visualization system.

How does Reshin design its monitors to meet hybrid OR requirements?

You need to procure monitors for your new hybrid OR but are concerned about finding a single model that combines all the necessary features—4K resolution, high brightness, low latency, and multi-modality support—in a medically compliant package.

We design our hybrid OR monitors by holistically integrating essential features: 4K resolution, high brightness (up to 800 cd/m²), ultra-low latency, and flexible multi-signal inputs (SDI, DP, HDMI). Our designs also feature sealed, easy-to-clean housings and medical-grade power supplies to ensure safety, reliability, and infection control.

Our design philosophy for hybrid OR monitors is rooted in a deep understanding of the clinical workflow and the unique technical demands of this environment. We do not simply assemble high-performance components; we engineer a fully integrated solution where every feature works in concert to enhance surgical performance and safety. This starts with a foundation of 4K Ultra HD resolution¹³, which provides the detail necessary for complex procedures. We pair this with high-brightness, high-contrast panels to ensure image clarity under any lighting condition. Our proprietary image processing electronics deliver the ultra-low latency required for real-time, image-guided interventions. The MS321PB surgical monitor exemplifies this approach. It combines a 32-inch 4K panel with versatile Picture-in-Picture and Picture-by-Picture capabilities¹⁴, allowing surgeons to customize their view from multiple sources. Beyond the core visual performance, we focus on the practicalities of the surgical environment. Our monitors are built with seamless, IP-rated front bezels¹⁵ that are easy to clean and disinfect, helping to maintain sterility. They use medical-grade power supplies to ensure electrical safety and feature robust, fanless designs where possible to reduce noise and prevent the circulation of airborne pathogens. This comprehensive design approach ensures that our monitors not only meet but exceed the demanding requirements of the modern hybrid operating room.

Conclusion

Essential hybrid OR monitor features—multi-modality support, low latency, high brightness, and versatile connectivity—are not just technical specifications. They are critical tools that enhance surgical precision, improve workflow efficiency, and ultimately contribute to safer, more effective patient care in complex surgical environments. To discover hybrid OR displays built for advanced surgical demands, contact Reshin at martin@reshinmonitors.com.