OPERATING THEATRES
Hybrid theatre design is a considerable art
With the percutaneous devices used in interventional radiology departments becoming ever more complex, and more and more minimally invasive procedures being undertaken in conventional operating theatres, a new ‘breed’ of ‘hybrid’ theatres has emerged, and is now a feature of many hospitals worldwide. Here Julian Grimaldi, senior business manager, Hybrid OR, for Getinge in Germany, examines some of the key considerations when designing, fitting out, and equipping such theatre spaces.
The hybrid room or hybrid operating theatre – an increasingly common phenomenon in 21st century hospitals – is a surgical room where both percutaneous and surgical procedures can take place thanks to the use of a C-arm imaging system integrated with a surgical table for complex patient positioning for hybrid procedures. The addition to a hospital of a hybrid operating room allows more innovative and efficient treatment and surgical procedures to be performed – resulting in better outcomes, shorter patient stays, and optimised workflows. Patient benefits include a speedier diagnosis to treatment process, access to innovative minimally invasive therapies that reduce recovery times, eventual elimination of corrective surgeries, and real-time availability of high quality imaging that helps surgeons preserve as much healthy tissue as possible. Among the benefits for hospitals are closer collaboration among specialists throughout the treatment chain, diagnostic advantages for new and innovative therapeutic techniques, the potential to enhance the hospital’s reputation, the ability to both increase patient satisfaction and boost revenues, and greater likelihood of attracting and retaining a high quality workforce.
Complexity of procedures increasing Over time, the complexity of hybrid surgical applications has evolved, and there is now increasing multidisciplinary use of hybrid facilities within hospitals – by specialities including neurosurgery, cardiovascular, orthopaedics,
traumatology, thoracic surgery, oncology, and urology. Today’s hybrid ‘ORs’ are also associated with a growing range of imaging modalities, with C-arms, CT, and MRI scanning equipment often used in combination with the surgical table (multi-modality intraoperative advanced imaging). This type of set-up is seen both on a standalone basis, and combined – in what is known as a ‘multi-modality hybrid OR’. The development of new methods
Getinge says the addition to a hospital of a hybrid operating room allows ‘more innovative and efficient treatment and surgical procedures’ to be performed.
of undertaking hybrid procedures has resulted in more complex workflows, and equally, radical new ways of designing surgical rooms.
Ensuring maximum workability To successfully design a complex and ‘futureproof’ multimodality operating theatre with sufficient flexibility to adapt to changing surgical and clinical trends, it is essential to find the right technology partnership for both the imaging technology and room design, and the equipment supply and installation. Of course creating a well-equipped, versatile hybrid theatre requires a substantial investment of time, a significant project management burden, and considerable capital outlay, so why are hospitals willing to invest in such facilities? The answer is that using an imaging system in combination with a surgical table gives the surgeon the best anatomical information possible in real time, and enables he or she to perform highly complex surgeries.
A hybrid room or theatre of this kind
is the only surgical environment within which patients can be diagnosed and treated at the same time. Surgeons can get quick and detailed information, and superior precision and control, while different specialties can work together to treat more complex cases. Surgeons can also check on the results of the surgery at any time during the procedure, and while applications using a surgical table in tandem with an imaging system are only currently in their infancy, we at Getinge believe they have a great future. For a successful hybrid theatre scheme, however, it is imperative that the hospital or theatre manager not only determines at the planning stage which surgical disciplines will make use of the hybrid theatre, but also considers the impact of, and interplay between, the room design and layout with the existing theatres and future workflows. Decisions also need to be taken early in the project on who will manage the scheme, which team will be assigned to it, and which technology partner can best ensure an efficient and smooth project implementation.
June 2018 Health Estate Journal 49
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