OPERATING THEATRE DESIGN
of the image – to the operating department area network. This allows us to take any of the images, signals, or communication from inside the theatre, and show it externally in training rooms, or to bring images and content back into the system. We can thus feed the theatre monitors from external sources.”
Fibre optic network
Richard McAuley continued: “Each medical device and its audio / video output is connected to a dedicated encoder, which take the images, audio, and control signals, and places them on a transport network, in this case fibre optic, which connects to a core network. The latter allows us to connect these devices to decoders, so we can then take the images and display them locally – on surgical monitors in the theatre, or send the data /signals across a dedicated network to, say, training rooms, where they can receive high resolution images directly from the OR. Being a network system, we’re not limited to a single operating theatre either; we can have multiple theatres connecting. Being in the network domain, we can transport this information to allow us to move images and audio over lower bandwidth networks, for instance using the Internet, a hospital’s own lower speed network, or even connecting to computer systems using Teams or Zoom to share content with a much wider audience.”
A modular design
Brandon can deliver all the component parts in a modular format, with all the pendant structures, support sets, and monitor arms, pre-cabled with all the necessary fibre infrastructure, terminated at a marshalling box on site. Richard McAuley said: “Our systems come with pre-wired assemblies, which can be supplied at different stages of the build. The entire system is controlled by a graphical user interface on a medical grade touch tablet, normally arm or pendant-mounted, so it’s easy for surgeons or theatre managers to control. “Because – as in the previous example Adrian discussed with our Medicontrol Intelligent Theatre Control Panel (iTCP) – this is a customisable touch panel user interface, we can align the user interface with the theatre equipment, so if we change an item, or the use of a display, we can reflect this on the touchscreen, and alter the network configuration to route the signals. We can also provide ‘windowed’ images to have full screen images of the content, or produce ‘picture in picture’ images locally, or even ‘quad view’ windows – which is particularly useful when taking information from the theatre and sending it to training rooms.” Not only, he added, was the transport mechanism for fibre optic infrastructure
52 Health Estate Journal August 2021
Many modern operating theatres feature dual surgical monitors, usually on an arm, plus, sometimes, a larger wall-mounted display.
not particularly expensive to deploy, but because of its significant bandwidth, it could accommodate not only ‘legacy equipment’ – such as standard definition HD video, but also newer equipment such as 4K camera control units, and technology expected to proliferate in the future, such as 8K video systems (which utilise considerable bandwidth, but are still well within the capability of existing fibre optic networks), ‘without having to substantially change the infrastructure behind it’.
‘Traditional hardware’
With this, Richard McAuley handed back to Adrian Hall, who explained that he would next focus on the installation of some of the ‘traditional’ operating theatre hardware – such as lights and cameras. He said: “Nearly all modern theatre lights and booms fit to standard mountings – typically this circular mounting (shown in a slide), with six M 16 or M 20 bolts with a 270 mm diameter pitched circle diameter. We thus start with a common mounting.” He added: “There is a very well-developed range of mounting solutions for such equipment. Take our own range, and the lighting and camera equipment generally mounts to steelwork or concrete via 2-3 selections of anchor mountings, with a range of standard mounting plates. We also offer a selection of different mountings that build down from the ceiling cavity space, including a selection
of frames, plus mounting or ceiling columns that fit below. It’s probably at least 10 years since I faced a new mounting problem. Once you’ve built the mounting down to the ceiling line, you then select which type of arm goes below that – whether a full central axis, a lightweight axis, a single ceiling column, or a tandem mounting. Similarly, we offer a choice of support arms, usually spring weight-compensated to take the load of the screen or lamphead. You then have a choice of lampheads, such as camera heads for an AV solution, or monitors and monitor brackets for a boom arm monitor solution.”
iBEPU is an application used to configure Brandon Emergency Power Units ( BEPU) using NFC.
Highly configurable theatre lighting While Brandon Medical has sold operating lights with embedded standard definition cameras for many years, high-definition, and in particular 4K video, had increasingly come to the fore. Adrian Hall said: “Our theatre lighting range is also highly configurable, so solutions can be configured for every application from stock, and it is now ‘routine’ with our overseas customers to configure and ship multiple operating light solutions within as little as 72 hours. Where equipment has perhaps not been very clearly specified, or the project requirements have changed moving towards installation, it’s often relatively easy to reconfigure the product.” Adrian Hall continued: “Clearly all these lights, monitors, and cameras, are electrical systems, and thus require a reliable, dedicated, medically compliant power supply with emergency supply back-up. We’ve developed our own easy- to-use emergency power package, which utilises integrated batteries in the event of power failure. To meet the IEC 60601 standard, you need parallel redundancy, with each lamphead supplied by its own emergency battery pack. We decided that if we were going to have a battery system, it should incorporate smart monitoring. So, we’ve integrated monitoring of our power
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