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THEATRE DESIGN


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.


assistant/circulating nurse. (Fig. 3). The shape of the OT was assumed to be as square as possible, with shelves embedded in the wall. In the study, we 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


40 Figure 6. The OT for cardiac surgery.


Equation 1. Total equipment area = OT size


– area of healthcare workers’ bodies/movement/traffic pathway – area of patient’s body/patient’s positioning/healthcare workers’ practice + size of operating table


Table 1. Main equipment and its size. Type


Routinely used equipment Operating table


Overhead instrument table Mayo stand


Prep stand (L) Prep stand (S)


Generator for coagulator Surgical field suction Anaesthesia machine Anaesthesia supply cart Vital sign monitor Intravenous pole


EMR cart for nurses Footprint (m2 ) Type 1.16


0.60 0.72 0.41 0.36 0.39 0.16 0.56 0.45 0.45 0.20 0.25


Chair for anaesthesia care provider 0.19 Footstool


Rubbish container (L) Rubbish container (M) Case cart


Area for


0.15 0.28 0.14 0.43


Footprint (m2


Temporarily used equipment Heart lung machine Cardioplegia


)


0.96 0.21


Percutaneous cardiopulmonary 0.30 support (PCPS) system


Intra-aortic balloon pumping 0.20 (IABP) system


Bed cooling machine


Patient warming machine Cell Saver


Trolley for endoscopy C-arm X-ray machine Surgical microscope


Surgical navigation system Generator for vessel


sealing device Sonic scissors


0.12 0.12


0.30 0.42 2.06 1.13


0.63 0.09


0.24 6.0 m 2.0 m 6.0 m 2.0 m 80 m2


Table 2. Average ratio of area of equipment in OT. Area for


Average


routinely used equipment (m2


11.87 )


temporarily used equipment (m2


) 1.52 )


Ratio of area 78.46


equipment 0.15


Ratio of


OT size of routinely used total area of (m2


equipment 0.17


IFHE DIGEST 2020


8.0 m


8.0 m


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