Operating Theatre Design: A Practical Guide to Planning Hospital Surgical Spaces

Designing an operating theatre is a detailed process that forms a critical part of any hospital’s infrastructure. This guide explores the essentials of operating theatre design, focusing specifically on the operating theatre itself, rather than the entire suite.

An operating theatre typically includes adjoining rooms such as:

• The Anaesthetic Room

• Scrub Room

• Clean Preparation Area

• Dirty Utility Room

In some smaller or older facilities, the anaesthesia process may take place within the theatre itself due to the absence of a separate room.

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Recommended Dimensions

While dimensions vary based on hospital type and procedure complexity, a good benchmark is around 7 metres wide by 8 metres long (56m²).

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Core Design Principles

When designing an operating theatre, keep the following priorities in mind:

• Flexible and adaptable use of space

• Surfaces and equipment that allow thorough clinical cleaning

• Ease of operation and access to panels, pendants, and surgical lighting

There is ongoing debate between keeping all equipment mobile (on trolleys) versus fixing items onto ceiling-mounted pendants. If the latter is chosen, ensure the ceiling slab can support the load. Early consultation with structural engineers is essential.

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Ceiling-Mounted Equipment

1. Surgical & Anaesthetic Pendants

Expect to install at least one surgical and one anaesthetic pendant, which provide power, gas, and data outlets. Fully articulated pendants offer the highest flexibility. Coordinate closely with:

• Structural engineers

• Electrical and gas contractors

• Mechanical consultants

2. Theatre Lights

Traditional halogen or gas discharge lights are being replaced with LED surgical lighting, which offers:

• 20,000+ hour bulb life

• Low maintenance

• Variable colour temperatures (aiding cancer diagnostics)

A 3-hour battery backup is recommended to ensure visibility during power failures. Emergency lighting should share this backup.

3. Monitors & Cameras

In teaching hospitals, include:

• HD or 4K ceiling-mounted cameras

• Pendant-mounted displays

• Wireless microphones for audio transmission

Ensure adequate bandwidth and power supply for high-quality data and video streaming.

4. Ultra Clean Ventilation (UCV) Canopy

Required for orthopaedic and neurosurgery theatres, UCV canopies affect the placement and sequence of ceiling services. Recent trends favour flush-mounted skirtless designs, offering better aesthetics and cleaning efficiency.

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Wall-Mounted Equipment

1. Surgeons’ Panels

Modern panels are:

• Flush-mounted

• Membrane type with anti-microbial coatings

• Increasingly touchscreen-based for ease of use and future-proofing

Coordinate installation of:

• Gas alarms

• IPS/UPS systems

• Warning signs (e.g., X-ray or laser in use)

2. PACS Display and Computer Systems

Install DICOM-compliant PACS screens near the main control panel. Surgeons also require access to computer terminals for logging procedure data – either wall-mounted or on mobile trolleys.

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Floor-Mounted Equipment

1. Operating Table

Typically mobile and battery-powered, but power outlets should be provided via pendants where needed.

2. Trolleys

Used to hold anaesthesia equipment and endoscopes. Their mobility aids cleaning and room reconfiguration.

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Infection Control & Airflow Design

Hygiene is paramount in an operating theatre. Ensure:

• Walls: Painted with chemical-resistant plastic enamel

• Ceiling: Airtight, typically plasterboard or metal

• Airflow Regimes: Directed from clean to dirty zones to maintain sterility

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Final Thoughts on Operating Theatre Design

We hope this article has provided helpful insights into the planning and specification process of operating theatre design. To get an idea on Ophthalmic Theatre guidance, you may want to have a look here If you’d like help reviewing or developing your theatre layout, we offer a consultancy service. Please leave a comment or visit our Contact page.

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