THEATRE DESIGN
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, 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 surgery are relatively rare. We do not believe that a universal model for this type of surgery is necessary at present.
OT size may be influenced by the theatre layout, which is based around the particular hospital’s cultural background.4 In the UK, HBN 265 sets out a different layout for operating theatres, and suggests that each should have its own anaesthetic room and integral scrub room. The minimum required OT size in HBN 01-01, Cardiac facilities8 was close to the size set out in in the 2018 FGI guidelines regardless of the basic OT layout. Thus, there is a possibility that our model can be applied to the UK model. Considering the user’s standpoint There are many measurement scales around which to base models of appropriate OT size. Guidelines for operating theatres published to date have tended to be based around functionality and architectural structure, but have hardly incorporated the user’s viewpoint, as we have done in our study. In fact, we discovered that the minimum required space adhering to previous guidelines was almost identical to
C-arm X-ray machine
Rear table for surgical instruments
Navigation machine
X-ray monitor
Standard-sized operating theatre
Surgical microscope
Table for specimens
100 m2 2.0 m 6.0 m 2.0 m
Figure 8. The OT for multi-subspeciality surgery.
the ‘unsatisfactory’ OT size in the OT directors’ responses, while ‘satisfactory’ OT sizes were almost identical to the OT sizes proposed in our model. We believe that high user satisfaction is another major advantage of our model.
User satisfaction is, of course, different from the efficacy of the OT. The feedback obtained in our study could have been markedly different had we factored in different questions to our survey of surgical personnel. Nevertheless, our study sheds light on the user’s standpoint on OT design. Previous studies have focused mainly on OT cleanliness, rather than efficacy. Our model should be tested in terms of efficacy or functionality using OT performance in the future.
References
1 The Facility Guidelines Institute. Guidelines for Design and Construction of Hospital and Outpatient
Facilities, 2014 edn. Dallas; p168-71.
2 Essex-Lopresti M. Operating theatre design. Lancet 1999; 353 (9157): 1007-10.
3 Clemons BJ. The first modern operating room in America. AORN J 2000; 71 (1): 164-70.
4 Essex-Lopresti M, Hubert D. Planning operating- theatre suites. BMJ 1962; 1 (5290): 1470-3.
5 NHS Estates. HBN 26 (Vol 1) Facilities for surgical procedures. The Stationery Office, UK; 2004.
6 The Facility Guidelines Institute. Guidelines for Design and Construction
of Hospitals. 2018 edn. St. Louis; p180-3.
7 US Department of Veterans Affairs. Surgical and Endovascular Services Design Guide. 2016.
8 Health Building Note 01-01: Cardiac facilities. Department of Health, 2013; p16-8.
CSJ Acknowledgement:
This study was partly supported by Working Group 1 of the Congress of OR Management, National University Hospital, Japan.
Surgical Procedure Lens surgery
Brain tumour surgery Head & neck surgery CABG
AAA/TAA surgery Lung cancer surgery
Oesophageal cancer surgery Hepatobiliary/pancreatic surgery Colorectal surgery Spinal surgery
Arthroscopic surgery OBGY surgery
Urological surgery
Table 3. Satisfactory and unsatisfactory OT space according to type of operation. Satisfactory
OT space (m2) OT space (m2
46.3 69.6 56.2 75.5 74.3 61.7 66.7 62.3 57.7 68.0 66.5 50.3 54.7
38 I
WWW.CLINICALSERVICESJOURNAL.COM
34.9 53.2 41.5 51.8 51.7 44.4 46.7 46.4 43.4 51.6 45.5 42.4 46.5
Unsatisfactory )
Calculated space (m2
48 90 64 80 80 64 64 64 64 90 90 64 64
)
Space recommended by 2018 FGI Guidelines (m2
≥37 ≥56 ≥37 ≥56 ≥56 ≥37 ≥37 ≥37 ≥37 ≥56 ≥56 ≥37 ≥37
AUGUST 2019 )
8.0 m
2.0 m
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