INTEGRATED THEATRES


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 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 on who will manage the project, which team will be assigned to it, and which technology partner can best ensure an efficient and smooth project implementation.


The planning concept The hybrid OR is a composition of diverse components that need to work seamlessly as a singular functional unit, to ensure smooth workflows and clinical success. The need to accommodate a wide range of patient positioning across multiple surgical disciplines


Real-time availability of high quality imaging helps surgeons preserve as much healthy tissue as possible.


affects the placement of the surgical table, imaging system, lights, ceiling service units, and monitors. Equipment placement must also


be sufficiently flexible enough to accommodate the increased number of people in the operating theatre. Cardiac procedures often require a dedicated workspace for a perfusionist, and a heart/ lung machine. Neurosurgery often requires the help of microscopes and navigation systems. The anaesthetist may need additional flexibility in positioning. The use of 3D software supported by VR is especially helpful during the evaluation stage to help visualise avoidable collisions and workflow optimisation in design of the theatre.


Adapting to different surgical needs


Planners have the task of ensuring that the hybrid OR quickly adapts to the needs and preferences of each surgical discipline. Understanding the relationship between medical staff, equipment, and information flow, is vital to help planners create a safe and ergonomic environment, regardless of what type of surgery will be performed. The design of a hybrid OR require a systematic approach in a logical step-by-step manner.


The key steps should include:


Equipment placement must be sufficiently flexible to accommodate the increased number of people in the theatre.


38 l JULY 2018 l OPERATING THEATRE


n Selecting the wall system to be used – traditional construction versus flexible modular wall. This has a significant overall impact, since despite their initial higher costs, modular walls can reduce the time needed for, and cost of, future room modifications and technology


upgrades, bringing long-term savings


n Choosing the appropriate imaging system depending on surgical needs (C-arm, CT or MRI, or a combination), plus auxiliary equipment


n Determining the optimal workflow between the hybrid theatre and adjacent rooms


n Selecting a hybrid OR surgical table with interchangeable tabletops, including a carbon fibre floating tabletop and universal breakable tabletop with carbon fibre back rest, both to accommodate a wide range of patient positioning for different surgical procedures, and for the surgical team’s comfort


n Designing and integrating the air-conditioning system to ensure effective laminar flow and sterile working conditions for a range of different patient positions


n Selecting the ceiling-mounted equipment (surgical lighting, ceiling supply units), and determining the optimal positioning to ensure an effective surgical environment and interactivity between the various devices


n Evaluating the available digital integration systems to ensure effective image handling inside the OR, centralise documentation, enable communication with people outside the room, and control equipment functions


n Selecting an anaesthesia system n Determining the need for additional equipment (ultrasound, heart-lung machine, injector, robotics, microscopes, and navigation system) based on room utilisation.


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