Operation theatre technology

Presented by:
Fazeelat Akram
Lecturer
Faculty of Allied Health Sciences
OT
Table
 OBJECTIVES
• Students will understand about Ot table
• Students will understand about Parts of ot
table
• Students will understand about Adjustments
OF ot table
• Students will understand about Safety
system of OT Table
• Students will understand about Positioning
• Students will understand about Types of
Positioning on OT table
 INTRODUCTION
 Room where surgery is performed is
called an Operating Room (OR) or
Operation Theatre
 OR is different from other rooms in the
hospital because
i) The environment is controlled
ii) Special electrical wiring is done
iii) It is clean
iv) Different emergency equipment
 Inside the OR, the ambient temperature is
set to between 20-21◦ C
 The humidity is regulated to 50%. These
are achieved by air conditioners.
 Also incorporated into the inlet path of the air to
the OR are HEPA (High Efficiency Particle
Absorbers) filters which minimize the dust
entering into the OR
 INTRODUCTION

 The operation table on which

patient is positioned the
fully adjustable for: for surgery is
• Height,
• Degree of tilt in all directions,
• Orientation in the room,
• Articular breaks and lengths
 This allows manipulation the
of
patientin any position
maintaining proper body allignment.
while
 The surface is covered with a firm pad
that can be removed for cleaning
 ACCESSORIES
 Removable arm boards: allow extension of
the patients arms and hands for IV lines. This
surgical arm board is wider and provides a
broader surface on which to place the hand
 Leg holder: provide access to the knee
when it must be held up away from the table
surface. A special table top cassette
attachment accepts X-ray cassettes when
the operative procedure requires radiographs
 Back table: is a large table on which all
instruments are placed during surgery.
Before surgery, a sterile linen pack is opened
on to the table and sterile supplies are
placed. After donning gloves, the nurse
arranges these in an orderly fashion
 Mayo stand: is a tray supported by 2 legs that is
placed adjacent and very near to the operative
site. Instruments that are used frequently are
placed here where it is immediately accessible.
This stand is adjustable and may be placed
over(above) the table, but never in contact with
the patient.
 ACCESSORIES
 Gerhardth (overhead) table: is a combination of
Mayo stand and backtable. The overhead table
is positioned over, but not touching the patient.
The large surface of table provides access to
numerous instruments and supplies without the
use of a back table. The sizes and contours of
the table along with all the other accessories are
standardized to accommodate all patients
irrespective of their size. The table is also made
to withstand various weights.
 The table is powered by electromechanical or
electro-pneumatic methods. The table can be
operated by a hand control placed on the side.
 Hand control is a membrane type, feather touch
to adjust all electro-hydraulic movements. It is
shock free, operating on DC 12V with a flexible
cable.
 Most of the tables give a foot switch control
enabling the surgeon to manipulate it to his
comfort. The table is made up of stainless steel
with smooth contours. It can be cleaned easily
with spray disinfectants and blood removing
agents. Since it is electrically operated, the
leakage current should be tested periodically.
 SPECIAL FEATURES
 Operation table is used for general surgery
and other certain procedures. It provides
smooth, easy and accurate positioning.
 It is fully maneuverable by finger tip
operated feather touch keys on a remote
control hand switch.
 Unique, sensor controlled leveling for Lateral
and Trendelenberg positions.
 Movement is controlled by high pressure
electro-hydraulic system to achieve smooth
and efficient operation, without the slightest
jerk from start to the end.
 The manifold has flow control valves for adjusting the
desired speed of the table movement to high accuracy.
 Hydraulic motor pump with long operating life is fitted with
anti-vibration mountings and auto thermal cut-off.
 SPECIAL FEATURES …
CONTD.

 Remote control hand unit operates on extra safe 12V DC.

 Legible and easily identifiable symbols on switches
provide
correct selection of table positions at any stage of operation.
 Full length cassette tunnel to move X-ray cassette. Special quick
change clamp to hold cassette firmly at any position.
 Radio translucent top.
 Durable & hygienic base cover made of stainless steel.
 MANUAL ADJUSTMENTS
 Head section can be moved mechanically.
 Detachable for fixing neuro hand rest
 Table is mounted on castor wheels, its movement in the operation
theatre is smooth
 Mechanical pedal brakes for firm and rigid locking of table.
 When brake is released, the table is free to move on its castors
 ATTACHMENTS …..CONTD
.
 Shoulder support
 Lateral support,
Universal lateral support
 General purpose head
support
 Knee rest
 Knee crutches
 Raised arm board
 Arm board
 Kidney elevator
 Anesthetic screen frame
 Cassette holder, lateral
cassette hold
 Cassette tray
with adjustable
rod
 Douche tray, Douche tray
with drain bucket
 IMPORTANCE OF PROPER POSITIONING
Why do we need proper positioning?
 To maintain patient’s airway and avoid constriction or pressure on
the chest cavity
 To maintain circulation
 To prevent nerve damage
 To provide adequate exposure of the operative site
 To provide comfort and safety to the patient
 BASIC SURGICAL
POSITIONS
Four basic surgical positions
 Supine
 Prone
 Lateral
 Lithotomy
Variations include :
 Trendelenburg
 Reverse Trendelenburg
 Jackknife
 Fowler’s
 High Lithotomy
 Low Lithotomy
ONE LAST NOTE…

Positioning problems can result in

significant injuries and
successful lawsuits.
 SUPINE

 Most common with the least amount of harm

 Placed on back with legs extended and uncrossed at the ankles
 Arms either on arm boards abducted <90* with palms up
or tucked (not touching metal or constricted)
 Spinal column should be in alignment with legs parallel to
the OR bed
 Head in line with the spine and the face is upward
 Hips are parallel to the spine
 Padding is placed under the head, arms, and heels with a pillow
placed under the knees
 Safety belt placed 2” above the knees while not impeding circulation
 PRONE

 Anesthetized supine, usually on the stretcher, prior to turning

 Turning is synchronized and supported
 Face down, resting on the abdomen and chest
 Chest rolls x2 placed lengthwise under the axilla and along the sides of
the chest from the clavicle to iliac crests
(to raise the weight of the body off of the abdomen and thorax)
 One roll is placed at the iliac or pelvic level
 Arms lie at the sides or over head on arm boards (must lower arms slowly
to
the ground then bring them up in an arc to place on arm boards)
 Head is face down and turned to one side with accessible airway
 Forehead, eyes and chin are protected
 Padding to bilateral arms and under Knees
 Pillow placed under bilateral feet (for maintenance of foot extension)
 Female breasts and male genitalia must be free from pressure and torsion
 Safety strap placed 2” above knees
 LATERA
L
 Anesthetized supine prior to turning
 Shoulder & hips turned simultaneously to prevent
torsion of the spine & great vessels
 Lower leg is flexed at the hip; upper leg is
straight
 Head must be in cervical alignment with the
spine
 Breasts and genitalia to be free from torsion and
pressure
 Axillary roll placed to the axillary area of the downside
arm (to protect brachial plexus)
 Padding placed under lower leg, to ankle and foot of upper leg, and to
lower arm (palm up) and upper arm
 Pillow placed lengthwise between legs and between arms (if lateral
 arm holder is not used)
TRENDELENBURG
The patient is placed in the supine position while the OR bed
is modified to a head-down tilt of 35 to 45 degrees resulting in
the head being lower than the pelvis
Arms are in a comfortable position – either at the side or on
bilateral arm boards
 The foot of the OR bed is lowered to a desired angle
 Velcro adhesive MUST be checked prior to placing the
patient on the table padding
Surgical tape may be indicated to assure the table padding is
fixed to the table to prevent pad slippage
 In addition to a safety strap, strips of 3” tape may be used
to assist with holding the patient in the proper position
 Used for procedures in the lower abdomen or pelvis
Enables the abdominal viscera to be moved away from the
pelvic area for better exposure
REVERSE TRENDELENBURG
 The entire OR bed is tilted so the head is higher than the feet
 Used for head and neck procedures
 Facilitates exposure, aids in breathing and decreases blood supply to
the area
 A padded footboard is used to prevent the patient from sliding
toward the foot
 FOWLER’S

POSITION
Patient begins in the supine position

 Foot of the OR bed is lowered slightly, flexing the knees, while

the body section is raised to 35 – 45 degrees, thereby becoming
a backrest
 The entire OR bed is tilted slightly with the head end downward
(preventing the patient from sliding)
 Feet rest against a padded footboard
 Arms are crossed loosely over the abdomen and taped or placed
on a pillow on the patient’s lap
 A pillow is placed under the knees.
 For cranial procedures, the head is supported in a head rest
and/or with sterile tongs
 This position can be used for shoulder or breast reconstruction
procedures
JACKKNIFE
 Modification of the prone position
 The patient is placed in the prone position on the OR bed
and then inverted in a V position
 The hips are over the center break of the OR
between the body and leg sections
bed
 Chest rolls are placed to raise the chest
 Arms are extended on angled arm boards with the elbows
flexed and the palms down
 A pillow is placed under the ankles to free the feet and
toes of pressure
 The OR bed leg section is lowered, and the OR bed is
flexed at a 90 degree angle so that the hips are elevated
above the rest of the body
 Used in gluteal and anorectal procedures
 LITHOTOMY
 With the patient in the supine position, the legs are raised
and abducted to expose the perineal region
 The patient’s buttocks are even with the lower break in
the OR bed (to prevent lumbosacral strain) High Lithotomy
 The arms are placed on padded arm boards, tucked at the
sides, or placed across the abdomen
 The legs and feet are placed in stirrups that support the
lower extremities
 Stirrups should be placed at an even height
 The legs are raised, positioned, and lowered slowly and
simultaneously, with the permission of the anesthesia care
provider
 Adequate padding and support for the legs/feet should
eliminate pressure on joints and nervus plexus
 The position must be symmetrical
 The perineum should be in line with the longitudinal axis of Low Lithotomy
the OR bed
 The pelvis should be level
 The head and trunk should be in a straight line
 Outcomes
• Students have understand about Ot table
• Students have understand about Parts of ot
table
• Students have understand about Adjustments
OF ot table
• Students have understand about Safety
system of OT Table
• Students have understand about Positioning
• Students have understand about Types of
Positioning on OT table
 References

 Principles of surgical
technology by Fuller
Surgical instruments and
equipments by Arora
Yadav
www.slideshare.com