Gary Hamilton:  What if we can… Design an Operating Room of the Future

Senior Vice President, WSP Buildings USA

Read Below to Learn More on Designing an Operating Room of the Future

Surgery is at the forefront of modern medicine in many respects with advances in computer assisted technology and robotics already evident in operating rooms around the world. Image-guided procedures – sometimes called keyhole surgery – mean that fibre optics and video screens are already standard equipment for many surgical teams.

Using specialised tools and instruments for visualisation and control, surgeons can operate through keyhole-sized incisions, with machine intelligence and robotics aiding the human/machine interaction for delicate medical endeavours such as cardiac surgery.

Operating rooms – also known as operating theatres – are changing quickly, but the pace of technological change is outstripping the rate at which we can make alterations to our existing medical facilities.

What if we can design and build operating facilities for the future?  How will they compare to the spaces surgeons often work in at present? How can we maximise the benefit of continuous leaps forward in medical sophistication?

The answer lies in a judicious mixture of commitment and flexibility.  We need to commit resources to rethinking, redesigning and rebuilding operating rooms, while at the same time understanding that technologies will change and we must be flexible to embrace them.

Many of today’s hospitals were built more than 20 years ago before the wave of digital technologies that is transforming our lives.  At that time, creating access to operating rooms for large machines and supplying electrical power to accommodate them, was unnecessary.

Consequently, many surgeons are now carrying out intricate advanced procedures in cramped spaces that would benefit from improved lighting, air conditioning and digital connectivity, their technology options limited by their working environment.

There are risks, too. Bringing too many machines and devices into an operating room can reduce the effectiveness of the heating, ventilation and air conditioning (HVAC) system including its ability to meet load and infection control requirements.

An operating room designed for the future is flexible offering modular accommodation with ceilings that can be raised, walls that can be moved, and extra large doors that can be opened up to admit new machinery.  HVAC primed for expansion and the provision of more than adequate power and air change rate in the room to make the most of technology.

We can design and build these future-ready operating rooms right now, and within financial limitations we should aim to make the investment.  As well as improving surgical treatments today, the opportunities we can open up for future generations are vast.


Sahlgrenska University Hospital

WSP’s work at Sahlgrenska Cancer Centre in Sweden demonstrates the opportunities that already exist.  At this world-leading hospital and research facility, we developed systems to bring technologies including advanced X-ray machines and ceiling-mounted mobile MRI into an operating room.

Imaging and surgery were previously carried out in separate locations, but the new facility was designed to bring them into the same place to enable several specialists to focus on a patient’s needs simultaneously. Achieving this outcome demanded complicated buildings design work because an extensive range of technologies are involved including X-ray, Magnetic Resonance Imaging (MRI), Ultrasound, Computerised Tomography (CT) and Positron Emission Tomography (PET).

Our team developed systems to bring many of these technologies, including advanced X-ray machines and a ceiling-mounted mobile MRI, into one space. Images are displayed on monitors, both within the operating room and remotely, to enable specialist clinicians in different locations to monitor and participate in surgery in real time.

We designed solutions to make the operating room adaptable to future advancements in medical technology: the exterior walls feature removable panels, for example, so that oversized technical equipment can be manoeuvred into the space, when required.

Power supplies are fail-safe, a dynamic uninterruptible power supply (UPS) has been installed for the below-ground cyclotron that supplies the hospital’s PET scanners with radioactive isotopes, and there is back-up for other generators.

Key to our design for Sahlgrenska Cancer Centre’s was creating an optimum spatial structure to provide an effective workspace for clinicians and assure operational security for patients, and it is this type of thinking that we are bringing to operating room projects.

All over the world, surgeons are seeking spaces that are adaptable to future advancements in medical technology, artificial intelligence and robotics allowing them to stay at the forefront of research and treatment in their specialist fields.

As buildings designers and engineers, we can assist them in their quest. We can design operating rooms for the future right now.

About Gary

Gary Hamilton has 21 years of experience in design and project management, has written numerous articles for engineering and healthcare publications, published his 1st book on computation fluid dynamics application for the engineering industry and his most recent book, his memoir ‘Ghetto Youths Bible’.

He is a certified evidence-based design professional with the Center for Health Design, and has served as the American Society of Healthcare Engineers (ASHE) representative on the International Code Council Ad Hoc Committee on Healthcare (AHC). He was elevated to the senior status of ASHE in 2015.  We’re very proud to have Gary as our regional healthcare lead for the North East USA.

Hamilton is now serving as the senior project manager for a 500,000-square-foot addition to the Walter Reed campus of the Naval Facilities Engineering Command’s Uniform Service University of Health Science in Bethesda, Maryland.

Why not take a look at Gary’s memoir ‘Ghetto Youths Bible’ for an inspiring read about how Gary has got to where he is today. All proceeds are donated to his not for profit charity Dreams to Reality Foundation

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