EBME Forums Forums Management Medical Equipment Management Hybrid Theatre Design - roof or floor mounting ?

Hi all,
My hospital are building a new theatre and intend it to be a hybrid.
They are putting the cart before the horse a little and have decided on the table (Maquet) before even starting to think about the imaging system - they are fixated on a suspended system so they can swivel it to the side of the theatre when not in use but from what I have been reading there is a lot of debate regarding the degredation this system arrangement has to air purity and infection control in a laminar flow environment. Most of the literature I can find seems to be subjective pieces or mention studies that are hiding from me - does anyone have any links to evidence based studies of the effectiveness of one over the other Much appreciated
Cheers Andy

Floor or roof mounting what, exactly?

The great thing about overhead suspension is that it keeps the kit (whatever it is) off the floor! In the theatre it has the added advantage of being able to be moved around (re-positioned) to suit the surgical procedure in question.

If we are talking about moveable ceiling mounted pendants, I would always try to go for two in each theatre, and get as much on them (power outlets, medical gases etc.) as possible.

Ceiling suspended pendants should not affect air flows any more than the main operating lights will (and to a certain - but negligible - extent, do). Just pay special attention to the ceiling plan design (hopefully before the rooms are constructed).

Either way, any properly designed theatre should be able to overcome any of the points you mention.

In our hybrid theatre they will not allow ops that spill more than 10mls of fluid on the floor.
I have no understanding of this rule as it severely limits what can be done in there. It seems to be a very bad design if that is the case.
I have no real knowledge of these type of theatres, Andy can you shed any light on to this rule from your research.
many thanks
Robert

Remember (how could we forget?) that Google is your (our) friend!

Try:- "hybrid operating room"!

Lots of nice pictures there.

In fact, it seems that there's a lot of stuff like this available on the web.

PS The C-arm in our hybrid is floor mounted and when not in use gets in the way according to some surgeons.
Robert

Thanks Guys, Geoff, hybrid basically refers to an integrated high powered imaging system (a souped up II and sometimes an ultrasound) but in this case I was referring to the II. The surgeons here are adamant they want a roof mounted one they can swing away to the side wall when not required. The issue I have been trying to narrow down with evidence is the turbulence a roof mounted system causes in the air flow over the surgical site and the resultant compromise to hygeine - comments seem to be that a floor mounted system is preferable as its out of the direct flow but I can't find any studies to back this up. Rojo, yes, researching I have come across the complaint regarding access issues with floor mounted systems and the issues of floor contamination - although that does seem a very small amount of fluid contamination to be getting bothered about - I understood that the main issues are fluid ingress and retention in the table base and II mount - Personally I would have thought that it ahould have been designed so cannot get into the these otherwise if you severely limit the type of proceedure you can do why go to the expence of a hybrid?

Hi

I'm currently involved in a £6.5 million A&E redevelopment and I have worked on a £1.5 million endoscopy redevelopment. Current building regs/infection control stipulate that as much equipment as possible should be kept off the floor. However in practice in an operating theatre there's lots of equipment some of which can not be ceiling/wall mounted. The best system by far for a laminar flow would be a mobile C-arm system as it can be completely removed when not in use, which in turn will allow the laminar flow to do its job properly and when the theatre isn't being used for orthopaedics it's not in the way.

Hi Ian,
Thanks for your comments . In this case there is already a permanently mounted post in the middle of the floor - the table top actually slides on and off it with the unconcious patient already on it so we have a cluttered, for want of a better word, floor already - the II even if floor mounted has to be stationary as it and the table movements are linked electronically, similar to a Cath Lab. I am not so sure they are planning to use the theatre for orthopaedics - we're still at the stage I am sure we're all familiar with where the clinical staff have decided they simply must have to have a Hybrid theatre in the new development here and they will work out afterwards what to use it for! I am just hoping to steer them in the right direction and by canvassing opinion appear smarter than I really am.