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THEATRE DESIGN


Table 3. Satisfactory and unsatisfactory OT space according to type of operation. Surgical procedure


Satisfactory OT space (m2


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


used equipment measured 11.87 m2 to temporarily used equipment 1.52 m2


As a result, the average OT size was 78.46 m2


, with an overall ratio of 0.17.


(Table 2). The calculated ratios of the equipment were 0.14, 0.19, 0.14, 0.12, 0.19, and 0.11 for the minimum OT, standard OT, ideal OT, OT for cardiac surgery, OT for specific surgery, and OT for multi- subspecialty surgery, respectively.


Practicality of our model The OT directors of all 43 university hospitals answered the questionnaire. The average unsatisfactory/satisfactory OT sizes were 40.1/47.3, 52.4/65.9, 41.3/56.5, 53.4/75.5, 54.2/74.3, 44.1/62.8, 46.7/66.3, 46.8/59.6, 45.5/58.4, 52.1/66.8, 44.3/66.5, 41.3/50.6 and 46.9/55.2 m2


for


lens surgery, brain tumour surgery, head and neck surgery, CABG, thoracic/ abdominal aortic aneurysm surgery, lung cancer surgery, oesophageal cancer surgery, hepatobiliary/pancreatic surgery, colorectal surgery, spinal surgery, arthroscopic surgery, OBGY surgery, and urological surgery, respectively. (Table 3) The OT sizes that did not satisfy the


OT directors appeared to be close to the recommended minimum sizes in the 2018 FGI guidelines.6


On the other hand, the


calculated OT sizes in our model were almost identical to those with which the directors were satisfied.


Discussion Our results demonstrated that OT size could be determined by summation of the areas occupied by equipment, healthcare workers, their movement/practice, and traffic pathway. The 2014 FGI Guidelines for Design and Construction of Hospital and Outpatient Facilities1


presented a 42


Table for specimens


2.0 m 100 m2 Figure 8. The OT for multi-subspeciality surgery. IFHE DIGEST 2020 6.0 m 2.0 m


Navigation machine


X-ray monitor


Standard-sized operating theatre


, and .


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


)


Unsatisfactory OT space (m2


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


detailed basic concept to determine the minimum requirements of OT space for the first time. Although the 2018 FGI Guidelines also adopt the concept of total combined area, the circulating pathway and movable equipment zone were defined in a different way from ours. In addition, neither the exact figures of equipment footage nor the detailed alignment of the elements in the OT were provided. The OT size was not stratified according to the number of healthcare workers or the requirements for surgical equipment. As a result, the final formula of our model was distinctive from the previous one. When considering the optimal OT size,


)


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


there are so many standards to adhere to that it is difficult to understand the rationale easily. The Surgical and Endovascular Service Design Guide7 provides room templates to overcome these complexities, but it is still difficult to understand how 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


)


C-arm X-ray machine


Rear table for surgical instruments


Surgical microscope


8.0 m


2.0 m


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