Hybrid Operating Room Requirements: Space, Structure and Services

Room size and layout

A hybrid room is considerably larger than a standard theatre, because it must hold the operating table, a fixed or movable imaging system, anaesthesia, perfusion or robotic equipment where used, and enough free space for a full team and an emergency open procedure. Exact dimensions are set by the imaging manufacturer's site planning guide and by the local guideline adopted by the project, so do not assume a figure from a different project.

Plan zones as well as area: the sterile surgical zone, the imaging control room with a view into the room, the equipment room for imaging cabinets, the scrub and preparation areas and the routes for patient transfer. A layout that leaves imaging motion paths clear, and keeps trolleys and cables out of them, saves rework later.

Ceiling height and structural load

Ceiling-mounted imaging, surgical lights, pendants and monitor arms compete for the same space. Height must allow the imaging gantry or C-arm rails to move through their full range with lights and arms parked clear. Confirm the free height with the imaging vendor, the light supplier and the pendant supplier on one coordinated reflected ceiling plan.

Structural loads can be high. The structure above the false ceiling and the floor under the imaging system must be designed to the vendors' load data, so request it early and pass it to the structural engineer in writing. SIMEON suspension systems take up to four arms on one central axis and offer arms of up to 2,000 mm for hybrid ORs, and the patented Sim.FLEX design allows further arms to be added after installation.

Shielding, airflow and services

Where ionising radiation is used, shielding for walls, doors, windows and sometimes floors and ceilings must be designed by a qualified radiation protection expert, in line with the requirements of the relevant UAE authority. Confirm with your consultant which body and rules apply to your emirate.

Ventilation for an operating room usually targets low-turbulence, clean airflow over the surgical field, and heat from imaging equipment adds cooling load. Coordinate diffusers, laminar canopies and ceiling-mounted equipment so that arms and pendants do not disturb airflow; see our note on laminar flow and pendants. Plan power, UPS, data, medical gases and equipotential bonding with the imaging vendor's requirements.

Positioning pendants and lights

Pendants and lights should serve the surgical team without colliding with imaging movement. Use longer arms so that equipment can be parked away from the imaging path, and fix parking positions on the plan. Lojer Solido pendants can be configured as surgical or anaesthesia units and are built to order, which helps match them to a non-standard layout.

Display strategy matters too. A hybrid room often has large screens for imaging and endoscopy, and the OK07 family offers a holder for 32 to 60 inch displays; SIMEON Sim.FLEX arms also carry lights and monitors. Agree where each screen sits for the surgeon, the imaging operator and the anaesthetist.

Planning checklist

Use this list to open the design discussion, and add items from your guideline and your imaging vendor.

• Obtain the imaging site planning guide and agree the governing UAE guideline.
• Coordinate one reflected ceiling plan for imaging, lights, pendants and diffusers.
• Confirm structural load data for ceiling and floor with the structural engineer.
• Appoint a radiation protection expert for shielding design.
• Define ventilation, cooling, power and UPS needs with the MEP designer.
• Plan control room view, recording and display positions.

Support from Beckfinity

Beckfinity can supply manufacturer drawings and load data for ceiling equipment on request. To compare room concepts see the overview of the hybrid operating room and contact our specialists for the pendant and suspension layout.