Premier performers for the theatre

Like every other area of medicine, operating theatre practice and technology, and indeed the breadth and complexity of conditions now effectively treatable surgically, have developed considerably over the past 2-3 decades. With a growing emphasis on faster patient throughput, many more procedures are, for instance, now undertaken minimally invasively. Thinking on theatre design has thus had to cater not only for a significant growth in demand for laparoscopic and endoscopic surgery, but equally to consider how operating theatres can be made more ‘efficient’ – necessitating particular consideration being given to the ergonomic aspects of their design, such as, for instance, designing in ceiling-mounted pendants to hold key surgical and anaesthesia equipment. Kate Woodhead, technical editor of Health Estate Journal’s sister magazine, Clinical Services Journal, has worked as a specialist operating theatre nurse for the past 30 years, for the last 10 running her own consultancy, KMW (Healthcare Consultants), providing advice and expertise to healthcare clients on achieving the optimal operating theatre design and operational efficiency. Over this period she says the sophistication and capabilities of many types of theatre equipment have advanced ‘to an unprecedented degree’: “Probably the biggest thing to impact on surgery in the past 25 years has been the ever-wider range of procedures now undertaken laparoscopically and endoscopically,” she confirms. “With such procedures, patients can have their operation, have minimal time in hospital recovering, and be ‘back to normal activities’, within as little as a week.

Patients ‘calling the tune’

“While keyhole surgery requires some sophisticated, and often quite expensive, kit,” she continues, “given that patients, who call the tune, often do not want to be in hospital for long, and that minimally invasive surgery generally has significantly faster recovery times, many more hospitals are embracing laparoscopic and endoscopic procedures, and needing to equip their theatres accordingly.” Another major advance now starting to be seen increasingly, although Kate Woodhead concedes that such facilities are currently still more commonplace in the US, Germany, and Japan, than in the UK, are ‘hybrid’ theatres, where investigative procedures such as MRI and CT scans can be undertaken using ceiling or floor-mounted scanners within the theatre itself. Here the patient is scanned and operated on on the same table, speeding throughput and improving efficiency, since there is no need to move the individual to a separate imaging suite. Kate Woodhead said: “Having the scanners in the theatre also allows more accurate surgery, which improves patient outcomes.” The past 15 to 20 years had also, she explained, seen a growth in the use of specialist endoscopic theatres, one major driver being that, with the size and number of equipment stacks needed for such surgery, some conventionally-sized ‘general’ theatres were simply no longer big enough.