04.02.14
World class surgery
Source: National Health Executive Jan/Feb 2014
Work on a state-of-the-art hybrid operating theatre at Central Manchester University Hospitals NHS Foundation Trust is just weeks from completion. NHE talked to Mr David Murray, consultant vascular surgeon at Manchester Royal Infirmary, to find out more.
A new hybrid theatre suite under construction in Manchester is a first for the UK and one of the first of its type in the world.
The £6m new facility marks a “radical change” on everything that has come before at the Central Manchester University Hospitals
NHS FT (CMFT), according to consultant vascular surgeon Mr David Murray.
It is specialised for minimally invasive surgery, which is fast becoming the preferred technique for many patients and doctors. Procedures are performed through tiny openings rather than one large cut, avoiding the need for open surgery. Patients have a lower
chance of infection, a speedier recovery and less risk of blood loss, pain and scarring.
Mr Murray said: “Technology marches on, and there is a big push to incorporate modern technology into medical practice. To do minimally invasive procedures safely, you need state-of-the-art facilities – and that’s what CMFT has invested in.”
The plans for the new unit were originally developed more than three years ago, but construction work started at the end of 2013 and is due to be complete by the end of March.
Mr Murray explained: “It will allow us to do much more complex procedures in a much safer environment. The concept of a hybrid theatre is essentially having the very best of a normal ultra-clean operating theatre with the very best of live imaging, whether it’s on-table CT scanning, or on-table angiography.
“I’m a vascular surgeon and concentrate on those aspects, but across the board in every specialty these things are creeping in. There’s a cardiac angle, for example putting in percutaneous valves, as opposed to the patient having their chest cut open.
“We’re now a large trauma centre, so there’s huge advantages in having this type of facility for critically-ill people. You can take them up to a theatre like this and literally do any operation with all the back-up in the world. That’s a big feather in the cap for the trust.
“People with two pathologies, such as a big cancer and a large aneurysm, can be treated for both simultaneously. Having this facility minimises the chance of people having to go through multiple procedures, which has health and cost implications.”
Mr Murray said the suite includes very high-end equipment, making it one of only about five centres in the world offering such a facility. Having two theatres in tandem potentially makes it the best in the world, he added. “There will be nowhere else with this kind of facility.”
The theatre build is being done Maquet, part of German medical equipment providers Getinge Group.
Mr Murray said: “They have the most experience in building hybrid theatres in the world at present. They’ve ironed out a lot of the build issues.”
The actual imaging system being used is a Siemens Artis zeego, which looks like a huge robotic arm, and can be manoeuvred into position as required.
The equipment has been self-funded by the trust, which is engaged in a long-term PFI deal with Catalyst Healthcare (Manchester) Ltd.
Mr Murray made the point that the construction of the facility also fits into the wider context of vascular surgery reconfiguration.
The Vascular Society of Great Britain and Ireland (VSGBI) and the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have recommended that surgery be focused in fewer, higher-volume units to improve outcomes, and services around the country are currently being reconfigured.
NHS England says: “The evidence base concerning the relationship between patient outcome and the organisation of vascular services has become more extensive over the past few years. There is a strong evidence base that suggests that mortality from elective aneurysm surgery is significantly less in centres with a high caseload than in units that perform a lower number of procedures….This echoes meta-analyses of most complex surgical interventions and should be regarded as definitive and highly informative.”
Mr Murray added: “This state-of-the-art unit is going to be fit for purpose for essentially the whole north west of England.”
Avril Forde, vice president of Maquet UK & Ireland, told NHE: “Maquet are delighted to have been selected as the partner of choice by Manchester Royal Infirmary to design and build three state of the art operating theatres, two Hybrid OR’s and one conventional theatre. All three theatres will be fully equipped with Maquet operating tables, operating lights, ceiling service units with all products being fully integrated by Maquet’s digital integration platform TEGRIS. Maquet have been presented with a challenging construction programme, but the use of Maquet’s VARIOP modular building system for the wall elements ensures that specific areas can be constructed quickly and efficiently. We first began discussing this initiative with MRI over two years ago and it has been a pleasure to be a partner to such a prestigious trust.”
Tell us what you think – have your say below, or email us directly at [email protected]