Technology and the operating theatre

Declaration of commitment and Safety Policy - The success of ACQUA Klinik is highly dependent on our ability to perform operations safely and reliably. This is why ACQUA Klinik’s management is committed to safety as our highest quality objective. To achieve that objective, operational risks that could jeopardize our level of safety need to be identified early on and reported, and appropriate precautionary measures implemented promptly. All of the company’s employees are bound equally by this obligation. No employee and no member of management has the right to put other responsibilities before this responsibility for safety.

Office1 Untersuchungsraum ACQUA Klinik


The ACQUA treatment station is equipped with HD endoscopy devices for a detailed look inside the nose, neck and ears. Computer assistance means even tiny changes can be detected and analysed. A large display allows the patient to observe the findings in real time. The doctor uses a data set to already pinpoint resection limits and risk areas, which are later used in the operating theatre computer. For aesthetic procedures, the Office1 boasts simulation programs to define the desired result and save it as a treatment plan. The Office1’s mini-endoscopes and patient-adapted instruments facilitate gentle and minimally invasive post-treatment. This is also where the treatment results are documented three weeks and three months after the surgery.

Briefing Room - Aufklaerung


Information about treatment options or an upcoming operation is given in the Briefing Room, using animated videos, anatomical models and a 3D view of the patient’s data. This is also where anaesthesia is discussed. In the Briefing Room, a wide range of computer systems also support surgical planning. This is where the surgeon defines the operating limits and instrument paths in the operating theatre computer, which are displayed later in the operating theatre using the navigation system. In the case of facial surgery, ACQUA Face Planning® can be used to create a three-dimensional treatment plan on the patient’s face, which is then exported to the operating theatre computer. Finally, the Briefing Room is where the surgical team meet for their daily briefing, during which the Surgical Operation Manager discusses all of the day’s procedures with the other staff.

ORx-340 OP-Saal

ORx-340 and OR1®

With the KARL STORZ® OR1® fleet, ACQUA Klinik employs a highly advanced operating theatre system that has spent the last two decades successfully extending its market leadership in the field of integrated operation systems. In 2014, the 3

Surgical Management and Guidance System


The Surgical Management and Guidance System is one of the surgeon’s most important assistance systems. The operating theatre computer supports his or her work in the cockpit by delivering information about positions, distances from structures such as nerves and blood vessels, providing checklists for certain manoeuvres and controlling the rotational speed of surgical instruments according to predefined settings. Especially where visibility is poor, such as when accessing the frontal sinus or inner ear, it makes it possible to perform procedures that were hitherto inconceivable or only possible at a considerably higher risk. In every case and during every operation, it is of course the surgeon’s prerogative to make the final decision. Since the SMGS was introduced, the rate of near misses and complications at ACQUA Klinik has dropped significantly. Today almost all procedures benefit from this centrepiece of the operating theatre.

Waypoint Navigation HNO-Operation

Collision Warning®

The Collision Warning system will warn the surgeon if an instrument moves too close to the meninges or an important nerve. The surgeon is shown the decreasing distance on the main display. In addition, a loud warning signal sounds in the cockpit once the target structure has been reached. Numerous international publications have already demonstrated the advantages and benefits of this function. Today, Collision Warning®, which was mainly developed as part of collaboration between the company ErgoSurg (Munich), Karl Storz (Tuttlingen) and ACQUA Klinik, is routinely used in many clinics around the world.

Surgical Procedure Manager

Procedure Point Navigation®

Today, particularly important or difficult manoeuvres demand the entire surgical team. Critical here is the interplay between those involved and their correct adherence to the defined sequence of steps. Certain parameters need to be checked regularly and by a second person. To make sure these challenging situations always run as smoothly as possible and minimize the frequency of irregular developments, the software Surgical Procedure Manager® can consult the manuals on performing a surgical operation during the procedure itself. The operating theatre computer points out important steps to the surgeon, the Technical Officer (TOS) and the anaesthetist and asks for confirmation. This results in operational consistency: The procedure no longer varies from surgeon to surgeon or from day to day. This increases the quality but also the stability of our results.

Surgical Recorder

Surgical Recorder®

The ORx-340’s Surgical Recorder constantly records and stores video data from the endoscope camera (view of the instrument) and from the SMGS (navigational information) together with audio from the cockpit. Along with the technical logs and the protocol from the SPM® system, this makes it possible to track and evaluate every single operation, action and decision. If patients are interested, ACQUA Klinik can provide them with excerpts from this system to take home with them, in what we call “Your Surgery USB”.