1. Colchester Laparoscopic Jane Hendricks Bsc (hons) Surgical Care Practitioner: Laparoscopic Surgery Integrated Laparoscopic Operating Theatres: The Way of the Future? Essex Rivers Healthcare NHS Trust Colchester General Hospital

2. Colchester Laparoscopic Evolution of Laparoscopy at Essex Rivers Healthcare Trust n 1989 1 st laparoscopic cholecystectomy n 1992 1 st lap teaching course n 1994 Appoint 2 nd lap surgeon n 1996 1 st nurse teaching course n 1998 number of courses increase n 2002 1 st lap theatre in the UK opened n 2002 appoint lap surgeon & lap nurse n 2004 appoint lap surgeon & lap fellow n 2005 2 lap theatres opened. n 2005 launch of ICENI concept, education centre.

3. Colchester Laparoscopic Why n Current stack system to heavy to move, moving and handling. n Wiring system and button pushing complicated. n Having to individually set each piece of equipment, turn around times.

4. Colchester Laparoscopic The Tardis! n As you can see very complicated. n Problems when picture in picture is required n To many opportunities for baby technos to interfere n Which button do I press next? n Shall I plug this in here?

5. Colchester Laparoscopic What We Have Now

6. Colchester Laparoscopic One of The Two Lap Theatres

7. Colchester Laparoscopic Health and safety n Problems with old style theatres trailing cables, heavy equipment to manoeuvre. n Reduced patient access n Having to set up each individual piece of equipment.

8. Colchester Laparoscopic Computerised communication tower n SCB- Storz Communication Bus, future proofed. n AIDA-advanced image and data archiving, allows video editing, printing and part of EPR. n Media Control- powerful tele video conferencing system and transmission of images, can be used for telemedicine, telementoring and remote teaching

9. Colchester Laparoscopic Integrated Operating Theatre n State of the art n Scrub team controlled n Links together via interface, all surgical equipment including op table, room lights, diathermy, etc. n Future proofed, important.

10. Colchester Laparoscopic Advantages n Being boom mounted is important as this much safer for equipment. n Easier for staff to move, health and safety. n Enables us to position monitors where they are required. n Trailing cables are removed from floor.

11. Colchester Laparoscopic Advantages n Ease of use for all theatre staff. n Training time: by the end of two weeks regular staff where happy to use system on their own. n Touch screen enables circulator to change settings without entering sterile field.

12. Colchester Laparoscopic Advantages n Having the system all wired and mounted to the ceiling means that people can’t borrow it!! n Trouble shooting is much less complex as once system is set up less to go wrong, in theory !!!!! n Stops hybrid systems being used so always get best quality image.

13. Colchester Laparoscopic Location n As some equipment can be remote located less equipment in theatre. n Infection control issues etc n Computers are now smaller and as we now have flat screens the equipment occupies a smaller area.

14. Colchester Laparoscopic Picture in Picture. n On old system complex for people to remember. n Now even without any formal training, it is possible to produce PIP as is self explanatory.

15. Colchester Laparoscopic Advantages: remote controller n Allows the scrub person to alter settings and become more self sufficient less people in theatres these days. n Better as allows you to alter many other settings including light control, safety issue. - user friendly, as not on stand. - user friendly, as not on stand. -however need extra drape. -however need extra drape.

16. Colchester Laparoscopic Disadvantages n Training and competencies, however all specialities have new equipment. n Team approach ever more important, lap surgery is a team effort. n Initial stages reliant on company for problem solving until experience gained. n Getting funding!!

17. Colchester Laparoscopic Future Aspirations n DVD writer to store moving images on, storage still an issue. n Facility to always record the images. n Infra-red to remove the cables. n ?voice activation of real benefit, especially in times of stress!!!!. n More equipment to be remote located.

18. Colchester Laparoscopic Acknowledgements Professor Roger Motson Mr. Tan Aruampalam Mr Ralph Austin Mr Giles

19. Colchester Laparoscopic Thank You For your Time.

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