THEATRE DESIGN
excluded specific types of operating theatre equipped with large equipment, such as X- ray units used for angiography, CT or MRI units, or surgical robots..
Calculation of OT size using our model
We classified operating theatre type into six categories based on size, i.e. minimum OT, standard OT, ideal OT, OT for cardiac surgery, OT for specific surgery, and OT for multi- subspecialty surgery. In our model, we apportioned an additional area to the movement of equipment and people, in addition to the area devoted specifically to equipment. For the sake of research, we selected 13 representative surgical procedures – including lens surgery, brain tumour surgery, head and neck surgery, coronary bypass (CABG) surgery, thoracic/abdominal aortic aneurysm surgery, lung cancer surgery, oesophageal cancer surgery, hepatobiliary/pancreatic surgery, colorectal cancer surgery, spinal surgery, arthroscopic surgery, obstetrics/gynaecological (OBGY) surgery, and urological surgery. We assigned lens surgery to the standard operating theatre, head and neck surgery, lung cancer surgery, oesophageal cancer surgery, hepatobiliary/pancreatic surgery, colorectal surgery, OBGY surgery, and urological surgery, to the ‘ideal’ OT, and brain tumour surgery, spinal surgery, and arthroscopic surgery, to an OT for specific surgery. Cardiac surgery included CABG and surgery for thoracic/abdominal aortic aneurysm. No procedure was assigned to either a ‘minimum’ OT or an OT for multi- subspecialty surgery.
Validity of our model
Since our model is predominantly based on the area in the theatre occupied by healthcare workers and their movement/ traffic pathway, the remaining space is considered to be the equipment area. To validate our model, we used the ratio of this equipment area to total OT size as an indicator. Equipment used in the
Trolley for anaesthetic drug
Anaesthesia machine
6.0 m 6.0 m 36 m2 Trolley for surgical instrument Figure 3. The ‘minimum’ OT. 48 m2 Figure 4. The ‘standard’ OT. Table 2. Average ratio Area for routinely used 11.87
of area of equipment in OT. Area for
equipment (m2) equipment (m2 1.52
temporarily used OT size of routinely used total area of ) (m2
Average Ratio of area )
78.46
operating theatre consisted of the equipment routinely used in ordinary surgery and that temporarily used for specific surgery. The former equipment includes the operating table and anaesthetic machine, and the latter a heart lung machine, surgical microscope, or surgical navigation system. We calculated the average equipment size and OT size using the operative records and equipment usage at our hospital during April 2011. The actual footprint of the equipment was measured beforehand, as shown in Table 1, while we estimated the ratio of equipment size using our model based on the type of theatre. The total equipment area was calculated by subtracting the total space apportioned to healthcare workers, the patient, and their movement/traffic pathway/
equipment 0.15
equipment 0.17
practice, from the estimated OT size, using Equation 1. We compared the measured ratio in our hospital’s operative records with the calculated ratio according to the OT classification.
4 Practicality of our model
In the next stage of our research, we assessed the practicality of our model using the degree of satisfaction of the theatre directors (medical or nurse OT directors) of 43 national university hospitals nationwide. We sent them a questionnaire asking which OT was most frequently assigned to 13 representative procedures. They were asked whether they were happy with the size of OTs currently used for the aforementioned procedures. They were also asked to provide
Ratio of
Standard-sized operating theatre
Rear table for surgical instruments
Standard-sized operating theatre
Cell saver
Cardiopulmonary bypass
Table for specimens
2.0 m 64 m2 Figure 5. The ‘ideal’ OT. 36 I
WWW.CLINICALSERVICESJOURNAL.COM 6.0 m 2.0 m 6.0 m 2.0 m 80 m2 Figure 6. The OT for cardiac surgery. AUGUST 2019
8.0 m
6.0 m
8.0 m
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