Hybrid Operating Theatre Design in Hospitals: A Practical Overview

It’s a pleasure to be back on Hospital-Designs.com after a busy few months working on greenfield healthcare projects. We’ve been fully committed to our current clients and ensuring their interests remain protected. Now that things are stabilising, we’re excited to reconnect with our readers and share insights again.

In this article, I’d like to focus on a topic that’s rapidly growing in popularity: hybrid operating theatre design in hospitals.

What Are Hybrid Operating Theatres?

A hybrid operating theatre combines a traditional surgical theatre with advanced medical imaging equipment, allowing surgeons to view high-definition images in real time during procedures. These integrated environments reduce patient risk, eliminate the need for transfers, and speed up recovery.

Surgeons also benefit from improved success rates, shorter operating times, and enhanced precision due to the immediate availability of live imaging.

Space and Layout Requirements

Hybrid theatres typically require more space than conventional theatres due to the imaging systems and support equipment.

• Standard size: 65–75 m²

• Larger units: Up to 90–120 m² (less common)

• Technical room: Additional 10 m² for imaging cabinets, UPS systems, and cooling equipment

It’s crucial to allow space for:

• UPS to return the angio table to horizontal if tilted

• Backup systems to prevent image loss during power failure

• Heat extraction systems to manage cooling for imaging gantries and technical cabinetry

Support Rooms and Control Area

In addition to Scrub, Prep, and Dirty Utility rooms, a dedicated Control Room is essential. This operates similarly to a Cath Lab control room, housing the equipment needed to manage the imaging process and assist the surgical team.

The C-arm used for imaging can be ceiling-mounted, floor-mounted, or bi-plane (both), depending on the system chosen.

Flexibility and Functionality

Hybrid theatres must function as both a surgical theatre and an interventional lab. This means the imaging system needs to be easily movable when not in use.

• Older systems achieved this with sliding ceiling-mounted C-arms

• Newer systems use robotic floor-mounted arms that synchronise with tilting operating tables

• These can be “parked” away from the surgical zone when not needed

This versatility is what makes hybrid operating theatres so valuable in cardiothoracic, trauma, and vascular care settings.

Equipment Coordination and Ceiling Integration

Designing hybrid operating theatres is a complex process. You must coordinate:

• Theatre lights

• Surgical and anaesthetic pendants

• C-arms

• High-definition monitors (6–8 screens on sliding gantries)

• Radiation shielding

• Ventilation systems

All this equipment competes for space, especially in the ceiling. The layout must avoid clashes while ensuring the surgical team and control room staff maintain clear visibility.

Structural and Installation Considerations

Before converting or building a hybrid operating theatre, check:

• Access routes for large imaging equipment – door widths, corridor turns, and lift capacity

• Floor and ceiling structures – Can they support the equipment’s weight?

• Service trunking – Can power/data connections reach the table and control room safely?

Ignoring these can lead to expensive rework or installation delays.

For best practice guidance, consult the Health Building Notes on Specialist Theatres.

Planning Ahead Saves Time and Cost

Early-stage planning is critical for hybrid theatre success. A properly coordinated design reduces downtime, improves patient outcomes, and helps prevent budget overruns.

If you’re considering a hybrid upgrade or planning a new surgical suite, don’t leave it to chance. Speak with experienced healthcare design professionals early in the process.

💡 Explore our operating theatre design consultancy services
🏥 Read our introduction to hospital equipment planning

Supporting the Healthcare Design Community

We actively welcome students, junior designers, and healthcare planners looking to learn more about operating theatre design.

If you have a project, a design question, or a story to share about your workplace, get in touch with us – we’d love to hear from you.

📬 You can also use our contact form to reach out directly.