Stanford Medicine Newsletter: "Operating rooms of the future"

Both hospitals on the expanding Stanford Medicine campus have reinvented their surgical suites to support the techniques of today and the innovations of the future.

In the main building of Lucile Packard Children's Hospital Stanford, the new surgical and imaging suites opening at the end of June will complete the Treatment Center. At the new Stanford Hospital, opening in late 2019, the entire second floor will be devoted to surgery.

"Traditional operating rooms are giving way to interventional platforms that can support new surgical techniques and technologies," said George Tingwald, MD, director of medical planning for the new Stanford Hospital. Tingwald, who is both a surgeon and an architect, brings a unique perspective to planning surgical suites.

In the new hospitals, operating rooms, cardiac catheterization labs, angiography suites, endoscopy procedure rooms and imaging suites are grouped together in one space. Physicians from multiple specialties — surgery, interventional imaging, angiography, anesthesia and cardiac catheterization — will work together, side by side, in these new facilities.

Doctors at both hospitals are enthusiastic about the upgraded facilities and what they will mean for patient care outcomes.

"Ultimately, the capabilities of these surgical and interventional radiology suites will translate to patients receiving less radiation exposure, and spending less time under anesthesia and less time in the hospital overall," said pediatric general surgeon Dennis Lund, MD, interim CEO and chief medical officer for Stanford Children's Health.

Advanced capabilities

The new pediatric surgical center adds six surgical suites and four interventional radiology labs, giving the children's hospital the most advanced surgical, interventional and hybrid technologies available anywhere. It will nearly double Packard Children's capacity for pediatric surgical procedures, helping alleviate scheduling delays.

"The new suites bring an unprecedented collection of advanced technologies and procedural bandwidth for Packard Children's," Lund said. "And it's all contained within a relatively small footprint, which will optimize the efficiency of our care services in a whole new way." The Treatment Center also includes a state-of-the-art imaging center, which opened in December.
Before the new children's hospital opened, interventional radiology, nuclear medicine and surgical services were in different parts of the hospital campus. Now a patient can check into the Treatment Center and go from service to service within one area.

Integrated functions

The three acres of surgical floor space in the new Stanford Hospital will include 20 operating rooms and eight interventional/radiology rooms with fixed image-guidance. These surgical suites will be grouped together with imaging technology that includes two MRI scanners, one CT scanner and one interventional MRI scanner.

At 800 to 1,000 square feet each, the new ORs are more than double the size of those in the existing hospital. Overhead booms hoist lights, monitors and fixed equipment off the floors, freeing up space for movable medical equipment, robots and medical teams and trainees.

"The new ORs will have the most advanced technology, making surgery more precise and safer," said Mary Hawn, MD, MPH, professor and chair of surgery. "We will have the ability to route images to any screen in the room and view radiographic images alongside laparoscopic images." New glare-reducing green lighting will enable surgeons to see images clearly without plunging the OR into darkness, a key factor in the increasing number of procedures that rely on guidance from projected images.

The nearby interventional MRI will allow patients to be scanned during surgery, then returned to the OR with the images necessary to complete the procedure. Two copper-lined rooms provide radio-frequency shielding for procedures, such as deep brain stimulation, that require surgeons to take microelectronic recordings of brain signals without interference from nearby cellphones or medical equipment.

The surgical floor has a convenient, centralized area for registration and family waiting, and a combined pre- and postoperative area for patients.

Increased efficiency

Hybrid rooms merge the latest imaging, radiology and surgery platforms into adjacent surgical suites, where multistage procedures can now be performed at one scheduled time and location.

For example, when a patient is having a brain tumor removed in one of the neuro-hybrid suites, surgeons can take in-suite interventional MRI images to confirm that they removed all of the tumor before closing the surgical site. Previously, surgeons had to complete the surgery before they knew the outcome, which could mean the patient had to undergo additional surgeries. In addition, cardiac hybrid suites combine an OR with a catheterization lab, so care teams can perform a minimally invasive catheter procedure in conjunction with open-heart surgery.