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Wolf-Dieter Otte
Head
Clinic for Visceral and General Surgery
Marien Hospital
Wesel Germany
E: [email protected]
The best operating room (OR) table would be no OR table at all – but the idea of the floating patient who may be positioned in any direction will also remain a hypothetical fantasy for the next 20 years.
The demands made on an OR table are on the rise all the time. With the advent of large, centralised ORs, the table has to serve an interdisciplinary purpose. This requires a modular construction, a high degree of flexibility and excellent handling through central OR preparation and modified transport systems. The operation positioning system has to be highly mobile and multifunctional when not on the OR table column.
Greater flexibility is needed
In the operating theatre and on the column what is called for is maximum mobility in all directions, radiolucency in all areas and much greater flexibility in patient positioning – for example, with arthroscopic surgery or endoscopic routines in the vicinity of the abdomen.
One aspect not to be neglected is the increasing body weight of the general population, and the possibility and necessity for operative care of very adipose patients. Therefore, much greater capability is demanded of the OR table.
New OR table possibilities
New possibilities such as a transport system, with the corresponding functionality for short and long journeys could be possible. The adjustability and modular construction of an OR table should be much more flexible – hardly any limits should be placed on positioning, allowing for the swift adoption of new developments in the future.
This means the operator could adopt an ergonomic position even if the patient is in an extreme position. Especially in laparoscopy it is a need to guarantee optimum exposition of the operating area with the corresponding positioning of the patient. All in line with the motto “Gravity does the work of at least one assistant”. Modular mattresses with polyurethane foam, decubitus mattresses and even vacuum mattresses have to guarantee optimum protection against bedsores, excellent support for the patient even in extreme positions and the best possible cleaning of components.
The accessibility of the patient is moving ever closer to the hypothetical idea of the floating patient, and the column position may be varied virtually completely from the foot end to the head end with the corresponding layout of the table.
Through the use of modern materials with electric motors and a hydraulic system, an operating table is much more robust, with the effect that even seriously adipose patients may be treated on the same table.
Conclusion
To summarise, no operating table system on the market yet squares the circle and allows for the hypothetical “floating patient” who is moveable in every direction and in all three dimensions. However, when it comes to mobility, there is one system that allows for 80% freedom when all the technical possibilities are utilised.
