Chapter 2: Operating Room Equipment

One of the most important pieces of equipment is the operating room table. Several different kinds of operating room tables are used, and the choice is often dependent on the type of neurosurgical procedure involved. The standard operating room table (Fig. 2.1) has many sections that allow a wide range of patient positions. Most people should be familiar with the tables’ controls and the different positions that these tables make possible. Most tables will also rotate to allow “airplaning” (lateral turning) the patient in either direction, so that more precise positioning can be obtained before and during most neurosurgical procedures. Most neuro-surgical procedures involving patients in the supine, sitting, and lateral positions can utilize a similar table. When a head holder is needed for supine patients, the most common are the Mayfield-Keys (Fig. 2.2) or the “horseshoe” (Fig. 2.3) head holders. For those patients undergoing a prone position procedure involving the head or cervical spine, this same table can be used with chest rolls and a stabilizing head holder, most commonly the Mayfield-Keys head holder. Spine procedures involving opening the disc spaces utilizing this general operating room table can utilize a Wilson frame added to the top of this operating room table. The Wilson frame arches the back and facilitates access to the disc spaces. For more extensive spine procedures, a different type of table is often used, which has an open construction, so the table does not compress the patient’s abdomen. A Jackson table, one of many of this type, has adjustable padding attachments on the sides to support the bony aspects of the pelvis while also padding the upper chest and providing flat panels for the knees. These tables are highly diverse in terms of what attachments can be added as well as how the table can be positioned. Most can be rotated, raised, or put in Trendelenburg positions. Other types of attachments serve the purposes of positioning, padding, and providing points for securing other pieces of equipment, such as arms or retractors.