General Operating Theatre Design

Designing an operating theatre outlines the intricacies of the hospital design process. An operating theatre suite consists of the Theatre, the Anaesthetic room, Scrub room and the Dirty Utility (or just Utility) room. We will look at planning just the Operating Theatre itself in this hospital design guide article. A number of facilities do not have a separate Anaesthetic room, anaesthesia is carried out in the operating theatre.

The size and room dimensions vary but as an indication it should be about 7 meters wide by 8 meters long (56 square meters).

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Over-riding principles while designing an operating theatre are:

  • Flexible use of the space;
  • Ease of clinically cleaning the theatre – including the floor, walls, surgeons panel and any equipment such as pendants and theatre lights;
  • Ease of use of surgeons panels, theatre lights and pendants.

There are different arguments for either having all equipment and instruments on mobile trolleys to allow 100% flexibility on use of the theatre and ease of cleaning the theatre versus mounting a great majority of equipment on ceiling mounted theatre pendants. The ceiling slab must be able to hold the weight of the theatre lights, pendants and the equipment if mounted on the pendants. It is highly recommended that you check with your structural engineer.

Ceiling Mounted Equipment:

1.  Pendants

Expect a Surgical and an Anaesthetic Pendant in any theatre which have power, data and various gas outlets. There are several major suppliers on the market with numerous different types. Pendants can be rigid, rigid-retractable or fully articulated. Theatres require fully articulated pendants for maximum flexibility. A lot of co-ordination is required between medical gas, electrical, and pendant trade contractors together with electrical, mechanical and structural engineers/consultants while installing pendants to ensure all structural steel support is in place, gas pipes are properly connected and power and data cables run at the correct programmed dates.

Various life saving equipment must be powered off Isolated Power Supply (IPS) which is also backed up by Un-interruptible Power Supply (UPS), in case of power failure during surgery.

2. Theatre Lights

There used to be the Gas Discharge lights or Halogen lights. Aspects to consider were bulb life, costs associated and Theatre down time while bulbs were changed.

There is a new kid on the block in the last few years – LED technology. About 30% more expensive compared to the existing technology but very long life bulbs (over 20,000 hours), ease of maintenance (couple of minutes to replace an LED), cheap cost of replacement (fraction of older technology) and ability to vary light temperature hence helping to diagnose cancerous cells etc.

Theatre Lights must be backed up by a battery back up in case of power failure during surgery. Suggested time can be 3 hours back up. Note that general lighting and emergency escape lighting should also be on similar battery/UPS back up time. The battery backup unit can be a large wall mounted cabinet about 1m x 1m and about 300-400mm deep. It will need to be mounted not far from the Theatre Lights but not inside the clinical space.

3. Camera

In a teaching facility, a camera (now a days High Definition Camera) and microphone is also required for one way video (from Operating Theatre to Lecture Theatre and/or Seminar Rooms) and two-way audio for surgeons and students to communicate. The camera can either be installed in the handle of the main Theatre Light of installed on a separate ceiling mounted arm. Consider all implications for power and data transfer (HD requires much higher bit rate transfer). Consider a wireless Reality TV / Big Brother style microphone on the surgeon to allow freedom of movement.

In Orthopaedic Theatres you would need to consider the largest ceiling mounted item – The Laminar Flow or the Ultra Clean Ventilation (UCV) Canopy. This item will need a separate article as we are planning a general Theatre in this article.

Wall Mounted Equipment:

1. Surgeons Panel

The panels can the older style steel type or the more current Membrane Type panels which allow ease of cleaning/disinfection. The membrane can be made anti-microbial by inclusion of silver nitrate. A newer version of panels can be touch screen which is now proving very popular taking over the mechanical switch panels and allows a lot of functionality simply by programming as the Theatre changes over time and new items are added and old removed.

For ease of cleaning and aesthetics, the panels should be flush mounted.

Note that all the pendants, theatre lights, general lights, gas alarm panel, IPS/UPS, and warning signs for X-Ray in-use / Laser in-use signs outside Theatre, air sampling ducts, clocks etc need considered and carefully co-ordinated among the trade contractors and design consultants for services and wiring.

Floor Mounted Equipment:

1. Theatre Table

Generally these are rechargeable and don’t necessarily require power socket close by.

2. Trolleys

Trolleys are used for instruments and equipment such as video endoscopes and anaesthetic equipment.

We mentioned ease of cleaning at the start. To enable this the walls should have special plastic enamel paint to allow chemical cleaning if required in case of disinfection. The ceiling is generally constructed of plaster board or special metal to ensure it is air-tight and easily cleaned.

Airflow regime is an important part of moving the air from clean areas towards dirty and out of the Operating Theatre suite to ensure the Theatre is the most clean environment for operating on the patients.

I trust the above has given you some basics to consider when planning your next operating theatre.

About the Author:
Harry McQue is a hospital Design & Equipment Manager with Post Graduate degrees in business management and information technology. Harry has 20+ years of international experience ranging from working on hospital projects in Dubai (Middle East) to over £1 Billion hospital projects in the UK & Europe. You can benefit from his experience at: If you have current or upcoming projects big or small or  topics that you would like his advice on, you can get in touch via the Contact page.

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