Intraoperatoire

Intraoperatoire, often written intraopératoire in French, refers to anything occurring during a surgical procedure. The goal is to guide the operation, ensure patient safety, and improve postoperative outcomes. Intraoperative management encompasses anesthesia, hemodynamic stability, blood loss control, and maintenance of sterile technique, as well as the use of real-time data to inform surgical decisions.

Real-time imaging and monitoring are common intraoperative tools. Imaging modalities such as fluoroscopy, intraoperative ultrasound, and intraoperative MRI or CT provide immediate anatomical and functional feedback. Neurophysiological monitoring, including electromyography and evoked potentials, helps identify and protect neural structures. Fluorescent imaging with dyes such as indocyanine green can visualize blood flow and tissue perfusion. In some centers, intraoperative pathology, including frozen-section analysis, guides margins and targets during tumor resection.

Applications span many specialties, including neurosurgery, spine and orthopedic surgery, vascular and cardiovascular procedures, head and neck oncology, and ophthalmology. Intraoperative navigation and robotics provide precision, while expanding to real-time image-guided decision making. Multidisciplinary teams coordinate to interpret data, adjust plans, and verify outcomes before wound closure.

While intraoperative approaches enhance accuracy and safety, they add complexity, require additional equipment and personnel, and may prolong procedures. Potential risks include anesthesia-related complications, infection, radiation exposure, and equipment failure. Proper training, protocols, and quality assurance help minimize these risks and standardize intraoperative decision making.