Operating Room Set Up Diagram: Positioning Equipment Around the Sterile Field

Zones inside an operating room

An operating room can be described in four zones. The sterile zone is the table, the surgical team and the instrument tables. The anaesthesia zone is at the head end of the table. The circulating zone is the non-sterile area around the periphery where the circulating nurse, mobile equipment and storage are placed. The access zone is the doors and routes for patients, staff and trolleys.

A good layout keeps each zone clear of the others, so that movement of non-sterile people and equipment never crosses the sterile field, and so that the anaesthetist and the surgeon each have a clear view of the patient and the monitors.

A baseline layout

Place the table centrally under the ceiling services, oriented so that the anaesthesia end faces the pendant or wall services and the surgical side faces the lights and displays. Surgical lights hang above the table on a suspension system, normally with two light heads and a camera or monitor arm positioned to avoid shadows and to keep the field in view.

The anaesthesia pendant sits at the head end, carrying gases, suction, power and shelves. The surgical pendant, if used, sits on the opposite side or at the foot, carrying power, suction and instruments or an endoscopy tower. Lojer Solido pendants can be configured as surgical or anaesthesia units, and the Q-Flow suspension family carries lights and monitors on SOLO, DUO, TRIO or QUAD arrangements.

Changes by specialty

Laparoscopy and endoscopy place the display opposite the surgeon, so monitor arms and towers matter more and pendants must carry insufflation, suction and video equipment. Orthopaedic rooms need space around the table for positioning aids, a large instrument area and often a mobile C-arm. Cardiac and vascular rooms add perfusion or imaging equipment, which extends the footprint and constrains the ceiling.

Neurosurgery and ENT often use microscopes, which need parking and reach, and plastic and general surgery usually need the simplest set-up. In hybrid rooms, imaging paths dominate, and long suspension arms are useful: SIMEON Sim.FLEX offers arms up to 2,000 mm with up to four arms per axis.

Drawing your own layout

Draw the room to scale and mark clear heights. Place the table, then the sterile zone and the instrument tables, then ceiling items with their full arm swing, then mobile equipment parking spots and routes. Check that no arm sweep crosses the sterile field when it is parked, and that doors open without hitting equipment.

Use the diagram in the design review with surgeons and nurses, and update it when the equipment list changes. Our guide on operating room design and layout explains how layout links to size and services.

Pre-operative set-up checklist

Before a case, the room is set up in a consistent sequence. Use a checklist agreed with your clinical teams.

• Confirm table position and attachments, and test movements.
• Position lights and check focus and brightness.
• Position pendants and check gas, suction and power outlets.
• Place monitors and cameras, and test the display chain.
• Set mobile equipment in its parking spots and check cables are off the floor.
• Check emergency equipment and suction before the patient enters.

Support for layout planning

Beckfinity can review a draft layout against manufacturer data for pendants and suspension arms. Send your drawings to our specialists to discuss the arrangement.