integrated laparoscopic operating theatres: the way of the future?

ColchesterLaparoscopic

Jane Hendricks Bsc (hons)Jane Hendricks Bsc (hons)

Surgical Care Practitioner: Laparoscopic SurgerySurgical Care Practitioner: Laparoscopic Surgery

Integrated Laparoscopic Operating Theatres: The Way of the Future?

Integrated Laparoscopic Operating Theatres: The Way of the Future?

Essex Rivers Healthcare NHS TrustColchester General Hospital


Evolution of Laparoscopy at Essex Rivers Healthcare TrustEvolution of Laparoscopy at

Essex Rivers Healthcare Trust 1989 11989 1stst laparoscopic cholecystectomy laparoscopic cholecystectomy 1992 11992 1stst lap teaching course lap teaching course 1994 Appoint 21994 Appoint 2ndnd lap surgeon lap surgeon 1996 11996 1stst nurse teaching course nurse teaching course 1998 number of courses increase1998 number of courses increase 2002 12002 1stst lap theatre in the UK opened lap theatre in the UK opened 2002 appoint lap surgeon & lap nurse2002 appoint lap surgeon & lap nurse 2004 appoint lap surgeon & lap fellow2004 appoint lap surgeon & lap fellow 2005 2 lap theatres opened.2005 2 lap theatres opened. 2005 launch of ICENI concept, education centre.2005 launch of ICENI concept, education centre.


WhyWhy

Current stack system to heavy to Current stack system to heavy to move, moving and handling.move, moving and handling.

Wiring system and button pushing Wiring system and button pushing complicated.complicated.

Having to individually set each piece Having to individually set each piece of equipment, turn around times.of equipment, turn around times.


The Tardis!The Tardis!

As you can see very As you can see very complicated.complicated.

Problems when picture Problems when picture in picture is requiredin picture is required

To many opportunities To many opportunities for baby technos to for baby technos to interfereinterfere

Which button do I press Which button do I press next?next?

Shall I plug this in Shall I plug this in here?here?


What We Have NowWhat We Have Now


One of The Two Lap TheatresOne of The Two Lap Theatres


Health and safetyHealth and safety

Problems with old style theatres Problems with old style theatres trailing cables, heavy equipment to trailing cables, heavy equipment to manoeuvre.manoeuvre.

Reduced patient accessReduced patient access Having to set up each individual piece Having to set up each individual piece

of equipment.of equipment.


Computerised communication towerComputerised communication tower SCB- Storz Communication Bus, future SCB- Storz Communication Bus, future

proofed.proofed. AIDA-advanced image and data archiving, AIDA-advanced image and data archiving,

allows video editing, printing and part of allows video editing, printing and part of EPR.EPR.

Media Control- powerful tele video Media Control- powerful tele video conferencing system and transmission of conferencing system and transmission of images, can be used for telemedicine, images, can be used for telemedicine, telementoring and remote teachingtelementoring and remote teaching


Integrated Operating TheatreIntegrated Operating Theatre

State of the artState of the art Scrub team controlledScrub team controlled Links together via interface, all Links together via interface, all

surgical equipment including op table, surgical equipment including op table, room lights, diathermy, etc.room lights, diathermy, etc.

Future proofed, important.Future proofed, important.


AdvantagesAdvantages

Being boom mounted is important as Being boom mounted is important as this much safer for equipment.this much safer for equipment.

Easier for staff to move, health and Easier for staff to move, health and safety.safety.

Enables us to position monitors where Enables us to position monitors where they are required.they are required.

Trailing cables are removed from floor.Trailing cables are removed from floor.



Ease of use for all theatre staff.Ease of use for all theatre staff. Training time: by the end of two Training time: by the end of two

weeks regular staff where happy to use weeks regular staff where happy to use system on their own.system on their own.

Touch screen enables circulator to Touch screen enables circulator to change settings without entering sterile change settings without entering sterile field.field.



Having the system all wired and Having the system all wired and mounted to the ceiling means that mounted to the ceiling means that people can’t borrow it!!people can’t borrow it!!

Trouble shooting is much less complex Trouble shooting is much less complex as once system is set up less to go as once system is set up less to go wrong, in theory !!!!!wrong, in theory !!!!!

Stops hybrid systems being used so Stops hybrid systems being used so always get best quality image.always get best quality image.


LocationLocation

As some equipment can be remote As some equipment can be remote located less equipment in theatre.located less equipment in theatre.

Infection control issues etcInfection control issues etc Computers are now smaller and as we Computers are now smaller and as we

now have flat screens the equipment now have flat screens the equipment occupies a smaller area.occupies a smaller area.


Picture in Picture.Picture in Picture.

On old system complex for people to On old system complex for people to remember.remember.

Now even without any formal training, Now even without any formal training, it is possible to produce PIP as is self it is possible to produce PIP as is self explanatory.explanatory.


Advantages: remote controllerAdvantages: remote controller Allows the scrub person to alter settings Allows the scrub person to alter settings

and become more self sufficient less and become more self sufficient less people in theatres these days.people in theatres these days.

Better as allows you to alter many other Better as allows you to alter many other settings including light control, safety settings including light control, safety issue.issue.

- user friendly, as not on stand .- user friendly, as not on stand . -however need extra drape.-however need extra drape.


DisadvantagesDisadvantages

Training and competencies, however Training and competencies, however all specialities have new equipment.all specialities have new equipment.

Team approach ever more important, Team approach ever more important, lap surgery is a team effort.lap surgery is a team effort.

Initial stages reliant on company for Initial stages reliant on company for problem solving until experience problem solving until experience gained.gained.

Getting funding!!Getting funding!!


Future AspirationsFuture Aspirations

DVD writer to store moving images DVD writer to store moving images on, storage still an issue.on, storage still an issue.

Facility to always record the images.Facility to always record the images. Infra-red to remove the cables.Infra-red to remove the cables. ?voice activation of real benefit, ?voice activation of real benefit,

especially in times of stress!!!!.especially in times of stress!!!!. More equipment to be remote located.More equipment to be remote located.


AcknowledgementsAcknowledgements

Professor Roger MotsonProfessor Roger Motson

Mr. Tan AruampalamMr. Tan Aruampalam

Mr Ralph AustinMr Ralph Austin

Mr GilesMr Giles


Thank You For your Time.Thank You For your Time.

integrated laparoscopic operating theatres: the way of the future?

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