THEATRE DESIGN
for cardiac surgery, OT for specific surgery, and OT for multi-subspecialty surgery, respectively.
Practicality of our model The OT directors of all 43 university hospitals answered the questionnaire. The average unsatisfactory/satisfactory OT sizes were 40.1/47.3, 52.4/65.9, 41.3/56.5, 53.4/75.5, 54.2/74.3, 44.1/62.8, 46.7/66.3, 46.8/59.6, 45.5/58.4, 52.1/66.8, 44.3/66.5, 41.3/50.6 and 46.9/55.2 m2
for
lens surgery, brain tumour surgery, head and neck surgery, CABG, thoracic/ abdominal aortic aneurysm surgery, lung cancer surgery, oesophageal cancer surgery, hepatobiliary/pancreatic surgery, colorectal surgery, spinal surgery, arthroscopic surgery, OBGY surgery, and urological surgery, respectively. (Table 3) The OT sizes that did not satisfy the OT directors appeared to be close to the recommended minimum sizes in the 2018 FGI guidelines.6
On the other hand, the
calculated OT sizes in our model were almost identical to those with which the directors were satisfied.
Discussion
Our results demonstrated that OT size could be determined by summation of the areas occupied by equipment, healthcare workers, their movement/practice, and traffic pathway. The 2014 FGI Guidelines for Design and Construction of Hospital and Outpatient Facilities1
presented a
detailed basic concept to determine the minimum requirements of OT space for the first time. Although the 2018 FGI Guidelines also adopt the concept of total combined area, the circulating pathway and movable equipment zone were defined in a different way from ours. In addition, neither the exact figures of equipment footage nor the detailed alignment of the elements in the OT were provided. The OT size was not stratified according to the number of healthcare workers or the requirements for surgical equipment. As a result, the final formula of our model was distinctive from the previous one.
When considering the optimal OT size, there are so many standards to adhere to that it is difficult to understand the rationale easily. The Surgical and Endovascular Service Design Guide7 provides room templates to overcome these complexities, but it is still difficult to understand how these standards are integrated into the recommended OT size. We believe that our model has a practical advantage of feasible applicability.
Ratios used
In our study, we validated our model using the ratio of equipment size to total OT size. Although the ratios varied from 0.11 to 0.19 depending on the OT type,
Standard-sized operating theatre
C-arm X-ray machine
Rear table for surgical instruments
X-ray monitor
Navigation machine
Rear table for surgical instruments
these figures were close to the ratio of 0.17 observed in our hospital. Looking at theatre size for multi-subspecialty surgery, nevertheless, the ratio of 0.11 appeared to be far lower than 0.17. We would suggest that this highlights the
difficulties in creating a universal model for collaborative surgery. In fact, the way that different surgical teams collaborate varies considerably between different hospitals, and changes as new technology emerges. Furthermore, these types of
Standard-sized operating theatre
C-arm X-ray machine
X-ray monitor Cell saver
Cardiopulmonary bypass
Table for specimens
2.0 m 90 m2 6.0 m 2.0 m
Table for specimens
2.0 m 90 m2 6.0 m 2.0 m
Standard-sized operating theatre
Surgical
Rear table for surgical instruments
microscope Cell saver
Table for specimens
2.0 m 90 m2 Figure 7. Three types of OT for specific surgery. February 2019 Health Estate Journal 27 6.0 m 2.0 m
Navigation machine
8.0 m
1.0 m
8.0 m
1.0 m
8.0 m
1.0 m
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