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An operating table, sometimes called operating room table , is the table on which the patient lies during a surgical operation. [1] This surgical equipment is usually found inside the surgery room of a hospital. [2] A specialized type of operating table, called a surgical fracture table (or trauma table), is designed to allow an orthopedic surgeon to perform common orthopedic procedures such as hip fractures, pelvic fractures, tibial fractures, fibula fractures, and anterior approach total hip arthroplasty. [3] Modern surgical fracture tables cost >US$200,000, but the costs can be reduced to make them more accessible using distributed digital fabrication with 3D printing of open-source hardware designs. [4]
An operating table system is basically made up of three components: an operating table column, the table top and the transporter. Modern operating table systems are available as both stationary and mobile units. There are a wide range of table tops that can be used for both general surgery and for specialist disciplines. Mobile operating tables, however, tend to be equipped with a specific discipline in mind. The base, column and table top form a unit.
Since the table column for a stationary operating table system is firmly anchored to the floor, the additional necessary medical devices can easily be brought to the operating area and positioned. These devices include, for example, x-ray equipment, which can easily be slid under the table top. For personnel, the system offers improved leg space since disruptive foot geometry is no longer present.
Additional elements can be adapted to the operating table. This flexibility is very important since it enables the table to be adapted to suit the relevant patient or the surgical discipline.
The advantage of the mobile operating table, on the other hand, is that the position of the table can be changed within the operating room. However, the foot of the table limits the leg space available to the surgical team. The individual segments of the table top can be easily removed and replaced. They also permit x-rays and conduct electricity.
Another special feature of the operating table system is the ability to use appropriate interface modules to establish communication with diagnostics systems, for example, angiography, MR and CT. This is only possible with stationary columns since the systems require a fixed point.
There are a number of basic functions that every operating table must fulfill in order to meet the requirements made of it. For example, the height of an operating table must be adjustable. This is the only way a surgeon can adapt it to their height and thus work ergonomically. In addition it must be possible to tilt the table to the left and to the right to ensure a better overview into body cavities or to use gravity to move organs (e.g. laparoscopy). In addition, the individual operating table segments must also be adjustable. This is the only way to ensure the necessary anatomical bends of the body and enable extremities to be positioned suitable for operating. A further property of the operating table top is radiolucency. The radiolucent surface should be as large as possible to ensure the largest possible image without disruption. The padding of the table is also important, this must be both soft and radiolucent. Soft because it must distribute the pressure optimally otherwise the patient may suffer pressure ulcers which staff may be liable for.
The operating table system has a number of advantages. Transport is easier since this unit is generally firmly secured to the floor and thus the foot and column of the unit no longer need to be transported. In addition, the transporter has light and large casters which are gentle not just to the floor. The entire operating area is more hygienic since the casters are not attached to the system, like on a mobile operating table. These are hard to clean and more unhygienic as a result. The operating table column can be rotated by 360° and offers ideal space for the feet of the team. The table top is, thanks to the use of x-ray-capable materials, almost completely radiolucent. The universal operating table is available as both stationary, mobile and moveable units. A mobile operating table is, however, used as a special table. The table top cannot be removed or replaced. Operation may, according to version, be manual, pedal or motorized.
Patients may suffer pressure ulcers as a result of lying incorrectly on an operating table or lying on an operating table for too long. Nursing staff and doctors try to prevent this from happening. Typical standard positions are, for example, back, stomach, side, Trendelenburg and a seated/half-seated position. The patient should always be positioned or optimally positioned in cooperation with the anaesthetist, surgeon and operating room staff. Prior to the operation, the decision must be made as to exactly how the patient is to be positioned. This decision not only takes account of the type of operation, it also considers the age, weight and health of the patient with regard to the heart, lungs, circulation, metabolism, blood circulation problems etc.
Unlike a mobile operating table which is usually employed in hospitals with small operating departments, for example, in ambulant operating rooms, modern operating table systems are characterized by their great mobility. They also have special table tops designed for a variety of surgical disciplines and, thanks to the ability to change these tops, they enable versatile use of an operating room. An operating table system with a stationary column is more stable and more hygienic. The better transport options improve the patient flow from the patient transfer unit and the operating room considerably. Finally, operating table systems with stationary columns enables control elements to be integrated into image procedures, for example, angiography, MR and CT.
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system including the brain, spinal cord, peripheral nervous system, and cerebrovascular system. Neurosurgery as a medical specialty also includes non-surgical management of some neurological conditions.
Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions, to alter bodily functions, to reconstruct or alter aesthetics and appearance, or to remove unwanted tissues or foreign bodies.
Mobile Army Surgical Hospitals (MASH) were U.S. Army field hospital units conceptualized in 1946 as replacements for the obsolete World War II-era Auxiliary Surgical Group hospital units. MASH units were in operation from the Korean War to the Gulf War before being phased out in the early 2000s, in favor of combat support hospitals.
An operating theater is a facility within a hospital where surgical operations are carried out in an aseptic environment.
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.
Remote surgery is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence. A robot surgical system generally consists of one or more arms, a master controller (console), and a sensory system giving feedback to the user. Remote surgery combines elements of robotics, telecommunications such as high-speed data connections and elements of management information systems. While the field of robotic surgery is fairly well established, most of these robots are controlled by surgeons at the location of the surgery. Remote surgery is remote work for surgeons, where the physical distance between the surgeon and the patient is less relevant. It promises to allow the expertise of specialized surgeons to be available to patients worldwide, without the need for patients to travel beyond their local hospital.
External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. As an alternative to internal fixation, wherein bone-stabilising mechanical components are surgically emplaced in the body of the patient, external fixation is used to stabilize bone tissues and soft tissues at a distance from the site of the injury.
An X-ray image intensifier (XRII) is an image intensifier that converts X-rays into visible light at higher intensity than the more traditional fluorescent screens can. Such intensifiers are used in X-ray imaging systems to allow low-intensity X-rays to be converted to a conveniently bright visible light output. The device contains a low absorbency/scatter input window, typically aluminum, input fluorescent screen, photocathode, electron optics, output fluorescent screen and output window. These parts are all mounted in a high vacuum environment within glass or, more recently, metal/ceramic. By its intensifying effect, It allows the viewer to more easily see the structure of the object being imaged than fluorescent screens alone, whose images are dim. The XRII requires lower absorbed doses due to more efficient conversion of X-ray quanta to visible light. This device was originally introduced in 1948.
In the United States Army, Medical Detachments, popularly known as Forward Surgical Teams (FST), are small, mobile surgical units. A functional operating room can be established within one and a half hours of being on scene and break down to move to a new location within two hours of ceasing operations.
A surgical nurse, also referred to as a theatre nurse or scrub nurse, specializes in perioperative care, providing care to patients before, during and after surgery. To become a theatre nurse, Registered Nurses or Enrolled Nurses must complete extra training. Theatre nurses can focus on different speciality areas, depending on which they are interested in.
Computer-assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for surgical planning, and for guiding or performing surgical interventions. CAS is also known as computer-aided surgery, computer-assisted intervention, image-guided surgery, digital surgery and surgical navigation, but these are terms that are more or less synonymous with CAS. CAS has been a leading factor in the development of robotic surgery.
Scrubs, sometimes called surgical scrubs or nursing scrubs, are the sanitary clothing worn by physicians, nurses, dentists and other workers involved in patient care. Originally designed for use by surgeons and other operating room personnel, who would put them on when sterilizing themselves, or "scrubbing in", before surgery, they are now worn by many hospital personnel.
Surgical positioning is the practice of placing a patient in a particular physical position during surgery. The goal in selecting and adjusting a particular surgical position is to maintain the patient's safety while allowing access to the surgical site. Often a patient must be placed in an unnatural position to gain access to the surgical site.
Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anaesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre.
Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for initially resuscitating and stabilizing and later evaluating and managing the patient. The attending trauma surgeon also leads the trauma team, which typically includes nurses and support staff, as well as resident physicians in teaching hospitals.
A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional, more invasive surgical part with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy imaging in a hybrid operating room (OR) without interruption. The hybrid technique has a reduced risk of surgical complications and has shown decreased recovery time. It can be used to treat numerous heart diseases and conditions and with the increasing complexity of each case, the hybrid surgical technique is becoming more common.
A hybrid operating room is an advanced surgical theatre that is equipped with advanced medical imaging devices such as fixed C-arms, X-ray tomography (CT) scanners, or magnetic resonance imaging (MRI) scanners. These imaging devices enable minimally-invasive surgery. Minimally-invasive surgery is intended to be less traumatic for the patient and minimize incisions on the patient and perform surgery procedure through one or several small cuts.
The 274th Forward Surgical Team (Airborne)—part of the 274th Forward Resuscitative and Surgical Detachment (Airborne)—is an airborne forward surgical team of the United States Army providing Level II care far forward on the battlefield. It was first constituted in 1944 and served in Europe during World War II. More recently it has been involved in relief operations following natural disasters and has undertaken several recent deployments to Iraq and Afghanistan. The 274th Forward Surgical Team was part of both the initial entry forces of Operation Enduring Freedom in 2001 and Operation Iraqi Freedom in 2003. Currently the unit falls under the command of the 28th Combat Support Hospital and is based at Fort Bragg, North Carolina.
Wrist arthroscopy can be used to look inside the joint of the wrist. It is a minimally invasive technique which can be utilized for diagnostic purposes as well as for therapeutic interventions. Wrist arthroscopy has been used for diagnostic purposes since it was first introduced in 1979. However, it only became accepted as diagnostic tool around the mid-1980s. At that time, arthroscopy of the wrist was an innovative technique to determine whether a problem could be found in the wrist. A few years later, wrist arthroscopy could also be used as a therapeutic tool.
G-arm medical imaging systems are based on fluoroscopic X-ray and are used for a variety of diagnostic imaging and minimally invasive surgical procedures. The name is derived from the G-shaped arm used to connect two X-ray generators and two X-ray detectors, image intensifiers or digital flat panel detectors, to one another. The main advantage of the G-arm, compared to a conventional C-arm system, is that it combines a pair of X-ray chains facilitating simultaneous views in two perpendicular planes, also called G-arm imaging.