3 Operating Room Setup

10.1055/b-0034-82079

3 Operating Room Setup

In the recent trend of minimally invasive and image-guided surgeries, the demand to redesign the conventional operating suite is increasing day by day. The common operation suite of the past is no longer able to cope with the enormous technical advancements and sophistication of modern surgical procedures. The excessive setup time, prolonged operative time, and slow patient turnover in older operating suites adversely affect productivity. The design of an operating suite is an important ingredient for a smooth and successful surgical procedure.

These needs were addressed starting in 1993 with the concept of a designated endoscopy suite or minimally invasive surgery (MIS) suite. These new suites are able to accommodate a plethora of ultramodern equipment and supplies while creating a harmonious environment leading to increased effcacy of surgical procedures and patient turnover. These dedicated MIS suites should have the following characteristics:

Spacious
Well-designed to accommodate related instruments and supplies, keeping ergonomics in mind
Designed to provide proper visibility for endoscopic procedures in which the visibility of monitors is of utmost importance for tissue orientation
Dust- and spore-free
Well ventilated

This chapter describes a pilot operation suite design and setup. This general design will require additional changes according to a particular surgeon’s needs and preferences.

The Layout of a Minimally Invasive Surgery Suite

The basic design of a modern MIS suite begins with a rectangular room of ~20 × 20 feet, although a larger size of around 30 × 30 feet would be preferable to accommodate a wider variety of MIS procedures. The ceiling should be around 10 feet high for mounting of the operating light, microscope, or C-arm.
The room should have adequate ventilation channels with temperature control.
A central gas (oxygen and nitrous) system, electrical points, and central suction valve should be moved to a ceiling mount mobile console or otherwise placed in the suite so as not to hinder the maneuverability of the surgical staff.
A laminar air flow system required to prevent growth of unwanted infective organisms.
In addition to the operating light, a spotlight system is handy for basic visibility in endoscopic procedures once the central light system is dimmed.
The room must have adequate storage space for surgical utility items.

Minimally Invasive Surgery Equipment

The basic equipment required for spinal endoscopy is as follows:

Operating table: A radiolucent operating table is mandatory for successful spinal endoscopy because it allows unrestricted anteroposterior and lateral fluoroscopic views. We generally prefer a Jackson table.
Endoscopy cart: This cart should be equipped with a video monitor, light source, video recording device, and irrigation pump.
Laser machine
Fluoroscope: This should be either mobile or permanently wall mounted. Some surgeons prefer a biplanar fluoroscope with two C-arms.
Radiofrequency generator
Microscope: A microscope in the surgical suite allows easy conversion to an open procedure.
Motorized endoscopic drill console
Anesthesia trolley equipped with infusion pump, emergency medications and pulse monitors, O₂ saturation, blood pressure, and electrocardiographic monitoring.
Irrigation fluid stand
Adequate storage space for effective organization of surgical utilities
A computer console for easy retrieval of the patient’s data