INTEGRATED THEATRES
infringe on surgeon’s headroom,6 delaying some of these projects and increasing the associated costs.
2000s
This decade saw another shift in focus within operating theatre design, with learnings from previous decades bringing discussion on future-proofing theatres to the fore. The arrival of the hybrid theatre concept, incorporating diagnostic technology within surgical theatre space to provide an integrated care platform, spurred these discussions.
Hybrid theatres require considerably
more space than traditional theatres, both horizontally and vertically; the extensive equipment that is often ceiling-mounted in these designs means that additional headroom must be catered for to minimise the risk of injury to personnel, making it challenging to retrofit hybrid theatres rather than building from new. Some types of hybrid theatre, such as angiography operating theatres, also require lead shielding of the walls, floors and ceilings, making refurbishment of existing space into a hybrid theatre a costly and disruptive process. Conventional theatres in this era also expanded, with guidance7 optimum size of 55m2
citing an . This updated
guidance also included newer ‘touch free’ technology in an ongoing effort to minimise contagion carried on the hands, including automated self-closing doors between the theatre and ancillary rooms and foot-operated waste receptacles.
Today In recent years, the increasing size of conventional operating theatres has come under scrutiny. With emphasis being placed on theatre efficiency and patient turnover, designers and manufacturers are querying whether these large theatres are the most effective. While larger theatre areas reduce disruption within the surgical environment, they also increase the travel distance for staff8 and can lengthen procedure times. A four-year study being conducted at the Medical University of South Carolina by researchers from Clemson University is aiming to design the footprint to a safer, more efficient operating theatre, utilising evidence- based simulations to determine the best size, shape and layout of the room to facilitate the safest and most efficient patient care. Designers are also
considering the further application of methods like interstitial floor spaces between storeys to allow additional room for ventilation systems, equipment and maintenance access. Further development of ceiling- mounting or underfloor equipment frames to allow for theatre layout adaptability continues, with architects juggling possible future requirements with the practical necessities of disruption, timescales and cost in a resource-light healthcare system. With physical space becoming
increasingly sparse in the UK, with many hospitals unable to further expand, research is also ongoing into utilising underutilised space within operating theatres, with concepts like the ‘self- contained’ operating table9
arising,
which makes use of the space beneath the table itself to store electronics, monitoring equipment and more.
OPERATING THEATRE l JULY 2018 l 59
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