The Operating Theatre Journal August 2021


The Operating Theatre Journal August 2021



SEPTEMBER AUGUST 2020 2020 2021 ISSUE ISSUE NO. NO. 360 360 371 ISSN ISSN 0000-000X


SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

The The Operating Theatre Theatre Journal





The The Leading Leading Independent Print Print & Digital & Digital Journal Journal For For ALL ALL Operating Theatre Theatre Staff


The Leading Independent Print & Digital Journal For ALL Operating Theatre Staff

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Messenger apps and patient confidentiality –

what every healthcare professional should know

Three years after GDPR rules were launched, many healthcare professionals are still failing to comply when sharing clinical

data via instant messaging

The global pandemic has provided a catalyst for the adoption of specialist digital communications tools which enable secure information sharing

and faster decision-making. Siilo - Europe’s largest medical messenger app – experienced a 202% increase in app downloads in the last 18 months


Privacy, security and data compliance should be at the forefront of every healthcare professional’s mind when sharing patient notes, photos and

sensitive data via messenger apps. Unfortunately, many of the most commonly used apps are not compliant. What’s more, we only have to look

at the recent ransomware attack on Ireland’s Health Service Executive (HSE) to appreciate the importance of data security within the healthcare


To help mark the third anniversary of the EU’s General Data Protection Regulation (GDPR) for healthcare compliance, Joost Bruggeman, CEO and

co-founder of Siilo, highlights the five key security features every healthcare professional should look for in their choice of messenger app.

Fingerprint/Facial Recognition & PIN code security

Facial and fingerprint recognition is a convenient way of accessing your apps securely. Including the additional layer of a personalised PIN code

gives you much greater security over the sensitive information on your phone, from photos to confidential patient information. These security

locks ensure your private messages are protected, helping to prevent other people from accessing them without permission.

An additional step taken by some messaging apps is the use of end-to-end encryption, where data exchanged is protected throughout the

chat process, encrypted when you send it and decrypted when it arrives with the receiver. End-to-end encryption provides the gold-standard

for protecting communication. In an end-to-end encrypted system, the only people who can access the data are the sender and the intended

recipient(s) – and no one else.

Image-editing features

Allowing images to be edited prior to being sent gives the user the opportunity to blur out any personal details, names, faces and birth dates

allowing images to be anonymised further protecting patient data. This is a step taken by Siilo to guarantee patient anonymity, as personal

information or identifiers can be removed or blurred by the sender in order to protect a patient’s identity. Alongside this, Siilo have included

another editing feature where critical areas of an image can be highlighted using the Arrow tool. This allows for the focus to be on the matter at

hand rather than anything else, streamlining the workflow process and saving valuable time. There is also no problem if the image isn’t correct on

the first attempt, with the ‘Undo’ function any edits to images can be reversed ensuring only the most accurate, relevant information is shared.

Processor agreements

Confidentiality is one of the pivotal factors that is required from a company, business or organisation when sharing data. Users must be reassured

that the data they provide is kept safe and confidential and that it may only be processed by authorised personnel and that third persons may not

access them.

Under Article 28 of the General Data Protection Regulation, a data processing agreement is a legally binding contract that states the rights and

obligations of each party concerning the protection of personal data. Essentially this ensures data privacy and security compliance at both an

organisational as well as an individual level. Within a messaging app this means that user data should be handled by the host platform securely

ensuring data protection.

Identity & medical verification

In the healthcare industry, trust is essential for both patients and practitioners. This has been amplified over the past year with the increased

move to virtual communication, which has highlighted that now more than ever security in relation to who you are contacting and sharing

information with online is paramount.

In some instances, apps will ask for verification by uploading an image of your photographic ID. This could be a driving license, passport or an

industry related ID such as your medical registration number. This helps to make sure that app users are who they claim to be, ensuring that any

potentially sensitive information is being sent and accessed by the intended recipient.

Separation between personal/professional media

Some messaging apps save photos automatically to your mobile phone library, which means that images shared securely within a chat are

then easily, and often unknowingly, saved to your personal device. It goes without saying that this is a huge problem when it comes to patient

confidentiality, especially if patient data is stored within these images.

This is generally a default option which then needs to be manually disabled by the user, but if the user is unaware of this even happening the

distinction between personal and professional files then becomes blurred. It is important to check what your messaging app offers and whether

these default settings can be turned off to minimise the risk of this happening. Some apps will allow you to save files and photos directly to their

app interface, allowing you to have a record of important files while ensuring they won’t be saved to your device or a cloud service.

Call for abstracts open:

submission deadline Friday 27 August

Programme, abstract submission and registration available:




SEPTEMBER AUGUST 2020 2020 2021 ISSUE ISSUE NO. NO. 360 360 371 ISSN ISSN 0000-000X


SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

The The Operating Theatre Theatre Journal





The The Leading Leading Independent Print Print & Digital & Digital Journal Journal For For ALL ALL Operating Theatre Theatre Staff


The Leading Independent Print & Digital Journal For ALL Operating Theatre Staff

Care Surgical; Continuing Expansion

Following the successful completion of our

rebrand in 2020, Care Surgical have continued

to push ahead with our expansion, investing

in our growing Research & Development and

Manufacturing Departments.

In 2021 we have invested in a brand new 5-axis

CNC for our manufacturing department,

upgrading from the VF2 to the VF7 to enhance

our existing in-house production capacity.

The addition joins our new high-frequency

welding machine and three new members

to our Research & Development team in our

expanded facility, complete with new CNC

area, high-frequency welding department and

new showroom area for virtual demonstrations

and webinars.

Our growing facility, teams and manufacturing capabilities reflect our ongoing commitment to designing

and manufacturing products that enhance patient outcomes, whilst keeping our Research and Development,

innovation and primary manufacturing in-house for quality-control and supply-chain efficiency.

With exciting new products in final-stage production, the team are looking forwards to the rest of 2021:

launching new products and continuing to innovate and elevate patient care in surgical environments.

For more information about our products visit

Why we need to take employee

sleep problems more seriously

We all know how to sleep – but not all of us do it

very well.

40% of UK population has sleep problems

20% of road deaths are related to fatigue

£40.2 billion is the cost to the UK economy caused

by sleep deprivation

(Figures from The Sleep Charity)

Sleep is not nice to have. It is an essential. Without

sleep, we would die. It is vital for the maintenance

of our physical and psychological health. Poor sleep

can have a negative impact on all aspects of life, at

home and at work.

To help people understand more about sleep, why

it matters and to help them get a better night’s

sleep if they are having problems, we have created

a new course featuring some of the UK’s leading

sleep experts.

“How to get good sleep” consists of 20 films, with

information split into three sections. Films are all

short and easy to understand, no more than five

minutes each. They is no jargon and they address

most of the questions you may be asking yourself

about sleep and how it can affect you.

To make these films, we’ve interviewed experts

at the forefront of sleep science. We’ve then

organized the material into sections to make it

easy to navigate. There is additional material in the

resources section.

The Mental Health Foundation is urging the

Government to take the problem more seriously.

Their recent report ‘Taking sleep seriously – sleep

and our mental health’ found that 35% of adults felt

increased anxiety as a result of poor sleep and 66% of

teenagers said sleeping badly had a negative effect on

their mental health.

Catherine Seymour, Head of Research at the Mental

Health Foundation, said: “Our research has revealed

evidence of the impact poor sleep is having on the

nation’s mental health. Sleep is a vital way to protect

our mental health and prevent mental health problems.

But it is not always easy to achieve this. “There are

many things we can do as individuals to improve

our sleep. But it is essential that we take a wholesociety

approach if we want to tackle poor sleep in

a comprehensive and effective way. That is why are

asking the Government to make the prevention and

treatment of sleep problems a key priority in their

mental health and wellbeing strategies.”


TeamDoctor has nationally accredited courses and a

substantial library of 3-5 minute films to help keep you

well at work. Our ‘Looking after your mental health at

work’ course, carries three CPD points. It is film based,

interactive, consists of four half hour modules, and can

be done at a time and pace to suit the individual user.

Here are just some of the subjects covered in our

Keeping Well at Work library:

Stress, anxiety, depression, presenteeism, workplace

relationships, management culture and structure, sleep

problems, workplace environment, how do get the best

diet when you’re at work and building more exercise

into your working day.


Inside this issue

Contact events in

rugby union linked

to reduced blood

flow to the brain

Anaesthetics team

commended for high

quality patient safety

and care

Find out more 02921 680068 • e-mail Issue 371 August 2021 3



UK Robotics New



Pioneering Hybrid Robotics

in General Surgery

at the CHUV


AfPP launches

Summer School


NHS in Gateshead to

make FFP3 masks


Owen takes on

triathlon challenge

for cause close

to his heart


Reflective gardens

and free media

services for patients



Augmented reality

project to help

train surgeons


Technology investment

will transform global



Study to pitch human

skill against robot


Sharps Safety in

Operating Rooms


ASGBI partners with



Practitioner Apprenticeship

Scoping survey


Fund surgery preparation

for those stuck on the

waiting list or risk a

grim outcome


A GROUNDBREAKING project to provide additional capacity for

endoscopy procedures is helping patients across Greater Manchester

access essential care and reduce waiting lists.

The project has been developed by the Greater Manchester Elective Reform Programme, Vanguard Healthcare Solutions

and 18 Week Support to create and operate a dual procedure endoscopy suite based at Fairfield General Hospital in Bury.

The Greater Manchester Elective Reform Programme, through the GM

Provider Federation Board, which brings together health providers

across the region worked together with Vanguard, one of the UK’s

leading medical technology companies, to create the innovative suite.

Designed bespoke to meet the Alliance’s specific needs, it includes a

Vanguard mobile laminar flow theatre with two procedure rooms which

has been seamlessly integrated with a multi-room bespoke temporary

modular building, also created by Vanguard.

As well as the two procedure rooms, the suite, which is set separately

to the main hospital building, also includes a six bed recovery bay,

two consultation rooms and full staff and patient facilities. The unit

has been specially commissioned by Greater Manchester Provider

Federation Board to support the delivery of endoscopy services across

Greater Manchester following the pandemic disruption.

To assist the Trust to staff the unit, Vanguard provide a unit facilitator

while 18 Week Support, the UK’s largest clinical insourcing healthcare

provider, have provided eight specialist endoscopy nurses and two

clinical consultants to deliver all patient endoscopy procedures and

ensure the unit is fully operational seven days a week. Reception and

porter services are provided by the Trust.

During its first six months the unit has been supporting patients from

hospitals across four Trusts including Pennine Acute Hospitals NHS Trust,

Manchester University NHS Foundation Trust, Stockport NHS Foundation

Trust and Salford Royal NHS Foundation Trust. Procedures carried out

include full colonoscopy, sigmoidoscopy and gastroscopy. On average,

each day’s list accumulates around 48 to 52 JAG points and lists are run

on a single-gender basis daily.

“Furthermore, waiting times for an endoscopic procedures have

reduced considerably as a result of the project.”

Simon Conroy, National Endoscopy Sales Manager at Vanguard, said:

“Feedback from patients and staff at the unit has been incredibly


“Many of the patients the unit is seeing are having surveillance

procedures and are, of course, very relieved and grateful to have

their appointments. Staff tell us it’s a light, bright, spacious and wellequipped

environment to work in and even that the unit provides more

spacious than standard endoscopy procedure rooms and recovery areas.

“We’ve been delighted to work with the GM Elelctive Reform Programme

and 18 Week Support to deliver this really important project, and that

we will continue to be part of the team delivering essential patient

care for another six months on site at Fairfield General Hospital.”

The project has been such a success that the initial six-month contract

has been extended for a further six months with the unit now due to

remain on site until the end of 2021.

Asia Bibi, Programme Manager at the Greater Manchester Elective

Reform Programme, who has been overseeing the project, said: “A

number of NHS partners have been working together to support the

recovery of services as a region and this is one of the first projects

to provide access for all regional patients. I am pleased at the pace

we have been able to set this up in order to restore services for our


Matt Marshall of 18 Week Support said: “This is an innovative project

which is helping the Trust significantly increase the number of their

patients that are seen by specialist clinicians, delivering significant

reductions in waiting lists and improving health outcomes. Using a

mobile unit separate to the main hospital building minimises disruption

and ensures patients can continue to be seen in a place where they

are accustomed to receiving their care. The patient feedback we have

had has been excellent, with patients telling us the treatment and care

they have received has been overwhelmingly ‘very good’.”

“We are pleased to be part of the team alongside Northern Care

Alliance and Vanguard and helping reduce waiting times for these

important procedures.”

When responding to articles please quote ‘OTJ’

The next issue copy deadline, Wednesday 25th August 2021

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The Operating Theatre Journal is published twelve times per year. Available in electronic format from the website,

and in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.

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A simple solution for improving

communication in the operating theatre

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Enter ‘OTJ’ in the discount section

Contact events in rugby union linked

to reduced blood flow to the brain,

impacting brain function.

Repetitive contact events incurred over a single season resulted in

professional rugby union players having a reduced ability to regulate

blood flow to the brain, which is essential for normal function.

The health consequence of this is crucial, as it may pay the way for

neurodegenerative disease later in life.

That’s according to new research published in The Physiological

Society’s journal Experimental Physiology.

Additionally, the researchers compared effects on players who were in

the position of forward versus back. Compared to backs, forwards were

involved in more contact events (such as tackles and collisions) and

demonstrated an accelerated decline in their ability to regulate blood

flow to the brain.

This research suggests that the decline in blood flow regulation was

related to an increased formation of invisible molecules called free

radicals that circulate in the bloodstream. In excess, they prevent blood

vessels from opening up as they should, to get oxygen and glucose to

the brain due to a shortage of nitric oxide, which causes blood vessels

to open.

Previous research in rugby union has predominantly focused on

concussion incidence, but the physiological toll of repetitive contact on

the field has not been investigated to date.

This new study addresses these gaps by highlighting the physiological

“signatures” of professional rugby players who are exposed to repetitive

contact sustained on the field.

This research can lead to improved treatment to mitigate the impacts

and make the sport safer for these players’ brains.

Previous research has linked concussion in rugby with neurodegenerative

diseases in later life.

This new study is the first to highlight that repetitive contact sustained

through participation in rugby union causes subtle, yet important

alterations in a player’s ability to regulate blood flow to the brain, over

a single season.

These changes may potentially pave the way for neurodegenerative

diseases in later life.

The researchers collected data before, during and after a season that

comprised 31 games.

Before the season began, they created a profile for each player based

on data including molecular (blood-borne), cerebrovascular (blood

flow regulation to the brain) and cognitive (memory, attention,

concentration) metrics.

During the season, they determined how many contact events each

player was exposed to throughout play. They also mapped concussion

incidence in order to determine which match event was most likely to

cause concussion. Following conclusion of the season, they reassessed

the players’ physiological profiles and mapped these against contact

events sustained throughout the season.

The research was performed on 21 players (13 forwards and 8 backs).

Future research is encouraged to confirm these findings on a larger


Commenting on the study, Professor Damian Bailey, senior author said:

“We hope that this study will encourage more rugby teams to engage in

larger scale studies of this nature to determine the life-long implications

associated with recurrent contact and concussion in rugby, including

the potential links to neurodegeneration in later life. Our ultimate goal

is to make the sport safer for the players and minimise the damage they

incur through contact.”

Full paper title: Link to paper

Find out more 02921 680068 • e-mail Issue 371 August 2021 5

The Operating Theatre Journal

Discovering the many more pages available online @

Sheffield Teaching Hospitals anaesthetics team commended for

high quality patient safety and care

The anaesthetics team at Sheffield Teaching Hospitals have been

commended by the prestigious Royal College of Anaesthetists for their

commitment to patient safety and excellence of care. In recognition of

the standard of care, the team have been awarded Anaesthesia Clinical

Services Accreditation (ACSA) accreditation once again.

ACSA is the RCoA’s peer-reviewed scheme that promotes quality

improvement and the highest standards of anaesthetic service. To

receive accreditation, departments are expected to demonstrate

high standards in areas such as patient experience, patient safety and

clinical leadership.

Dr Karl Brennan, Clinical Director, Anaesthesia and Operating Services,

Sheffield Teaching Hospitals NHS Foundation Trust, said: “We are

exceptionally proud of the care we provide to patients across the city,

so we are delighted to have achieved renewal of this prestigious award.

This is the culmination of over five years’ hard work and a fantastic

acknowledgement of the whole team’s ongoing commitment to

maintaining the highest standards of care. The last 18 months have been

exceptionally challenging for our teams and those we work alongside

and so to receive this news now is a real boost. However, we are never

complacent, and we will continue to look for opportunities to drive the

highest standards of care to our patients.”

Professor Ravi Mahajan, President of the Royal College of Anaesthetists,

said: “Achieving accreditation in the first place is a great accomplishment

and it is very impressive to see the commitment and approach of the

whole department to maintaining their standards and being re-accredited. It is richly deserved and demonstrates their commitment to providing

the best possible care for their patients.

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Photo: L-R: Evette Wilson Anaesthetic Associate, Emma Joel Nurse Director

Anaesthesia and Operating Services, Dr Ian Shaw Consultant Anaesthetist,

ACSA Lead, Jayne Turner Lead Practitioner and Nichola Hamblett Recovery

Sister at the Northern General Hospital.

It was also very impressive to see the innovative practices taking place

at the hospital.

As well as meeting the standards, the department demonstrated many

areas of excellent advanced practice that have now been highlighted

for sharing through the ACSA network.”

At Sheffield Teaching Hospitals the anaesthetic teams are based

at both the Northern General Hospital and the Royal Hallamshire

Hospital, providing specialist support to all the surgical specialities

within Sheffield’s five adult hospitals.

When responding to articles please quote ‘OTJ’


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Major new whitepapers outline skills, education and regulatory roadmap for accelerated uptake of robotics

technology across key applications in the UK

Two major new robotics whitepapers setting

out the vision for widespread adoption of

robotics technology across the workplace

and in surgical settings have recently been

published by the EPSRC UK Robotics &

Autonomous Systems (UK-RAS) Network.

These new landmark whitepapers – released

to mark the successful conclusion of the

inaugural Robotics Summer Showcase – were

launched during a virtual online event and are

freely available to download now:

• Preparing the workforce for 2030: Skills

and Education for Robotics & Autonomous




• Surgical Robotics: Towards Measurable

Patient Benefits and Widespread Adoption



The UK-RAS Network whitepapers are intended

to serve as a basis for discussing UK industrial

and social strategies, and for engaging the

wider community and stakeholders, as well as

policy makers.

The Skills and Education whitepaper explores

the need to reskill the current workforce to

work safely and effectively alongside robots, to

train managers to understand and effectively

deploy automation, and to ensure that, across

all levels of education, people from diverse

backgrounds have the skills they need to be

part of the 2030 workforce. The whitepaper

summarises the opportunities and challenges,

identifying promising recent initiatives in skills

training, both in the UK and across the world,

and highlights future interventions in UK-

RAS education that are both affordable and

scalable, and that could help the UK maintain

its place as a leading technological economy.

Lead authors for the Skills and Education

whitepaper include:

• Richard Waterstone – Co-Lead of SERAS, a

UK-RAS strategic task group for Skills and

Education in Robotics and Autonomous

Systems; MD Cyberselves Universal Ltd.

• Dr Patricia Charlton – Senior Lecturer in AI

and Data Science at the Open University

• David Gibbs – Senior Subject Specialist at

the National STEM Learning Centre

• Professor Tony J Prescott – Chair in Cognitive

Robotics at the University of Sheffield; colead

of the SERAS task group

The Surgical Robotics whitepaper revisits the

first UK-RAS whitepaper on the topic, published

five years ago, in light of the significant changes

in technology and regulatory processes, and

increased adoption. The new whitepaper

summarises the latest achievements in the

sector and offers a measured view about the

future of surgical robotics in the UK – including

the outlook for creating shared resources

and clusters, attracting a skilled workforce

from around the world and fostering

international collaborations. It also identifies

existing translational barriers and offers key


The lead authors for the Surgical Robotics

whitepaper are:

• Dr. Christos Bergeles, Associate Professor,

King’s College London

• Dr. Ana Cruz Ruiz, Manager of the Robotics

Forum and project manager for the UK

node of the EU project DIH-HERO, Imperial

College London

• Professor Ferdinando Rodriguez y Baena,

Professor of Medical Robotics and Co-

Director of the Hamlyn Centre, Imperial

College London

• Professor Pietro Valdastri, Chair in Robotics

& Autonomous Systems, University of Leeds

Commenting on today’s whitepaper launch,

Professor Robert Richardson, EPSRC UK-RAS

Network Chair said: “Both COVID-19 and

Brexit have accelerated the rise of robotics

in the social and economic life of the UK,

and we expect huge interest in these muchanticipated

publications from across academia,

industry and government. By drawing on the

UK’s world-leading robotics knowledge base in

these two key areas, these documents provide

a unique perspective on the unprecedented

challenges and opportunities ahead, as the

UK moves to become a leading player in the

4th Industrial Revolution. We’d like to thank

all the contributors to this important body

of knowledge, which provides an invaluable

blueprint for informing future strategies, and

cements the UK’s position as a robotics and

autonomous systems innovation powerhouse.”

The EPSRC UK-RAS Network’s first Robotics

Summer Showcase of cutting-edge robotics

research and innovation, which has run from

May through to the end of July, has delivered

a variety of free-to-register lectures,

workshops, demonstrations and unique events

held by Network partners. The UK Festival of

Robotics annual celebration was held at the

end of June, and was hosted by the EPSRC UK-

RAS Network as part of its mission to provide

academic leadership in robotics, including

coordinating activities at over 30 partner

universities across the UK.

For more information about the activities

held during UK Festival of Robotics and the

Robotics Summer Showcase, please visit:




© Marco2811 -

15 th International

Neurotrauma Symposium

Improving lives after neurotrauma through research

17–20 July 2022

Pre-symposium-courses scheduled for 17 July

Catch-up on some of the weeks’

operating theatre related news

via our page on Paperli.

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will keep you in the know!



Brandon Medical innovates to support carbon

reduction in healthcare in over 70 countries

Pledge to Net Zero is only a step to formalise what has been Brandon

Medical’s decades-long philosophy, both on reducing the carbon

footprint of our commercial activity, but not in the least, to innovate in

the space of turnkey acute care equipment in such a way to support the

carbon hungry healthcare around the world reduce emissions. Brandon

Medical equipment is installed in UK and over 70 countries around the


Brandon Medical has pledged to net zero and it is working towards a

complete policy. ‘Pledge to Net Zero’ is the environmental industry’s

global commitment, requiring science-based targets and demonstrate

leadership as well as taking strong actions to mitigate the most

significant impacts of climate change.

Brandon Medical series of innovations spanning two decades –

included in the SMART turnkey equipment for acute care that carry

the environmental ethic to decrease the huge carbon footprint of


- HD-LED innovation –Queens Award for Innovation in 2011 – replacing

energy hungry halogen with above the average performance LED


- iBEPU – the only SMART operating light emergency backup battery –

which can be monitored via NFC sensors with data collecting in the

cloud – and first visit.

- The Intelligent Theatre Control panel which can be upgraded and

updated remotely; the panel will turn off and run maintenance

routines when it detects the operating room is not in service

- The Symposia near zero latency 4K audio video system - allows

surgeons in training to attend surgeries remotely for training


- The i2i Quasar operating light (isolated to integrated), with segment

self-healing; cloud data collection allows first visit fix, or advice over

the phone if there is only a settings issue

- The Mediclean Ultra Clean Ventilation with CPM (continuous particle

monitoring) which automatically starts and stops depending on

number of particulates in the air, using no more and no less energy

than necessary for a high level of safety for patients and staff

Last, but not least two decades of expertise in configuring acute care

areas for a regulatory and recommendatory compliant solution - with

high levels of engineering contingency and resilience while maintaining

a commercial design philosophy allows Brandon Medical to provide MMC

(modern methods of construction) modular equipment which can be set

up off building site.

Internally, Brandon Medical’s initiatives are practical, small evolutionary

changes to the business, but over time they set a direction and their

impact builds. These initiatives include:

- Move to natural and recyclable packing

- Recycle and reuse all incoming packaging

- Introduced recycling marks on plastic parts

- Introduce carbon monitoring

- Upgrade building to modern eco standard

- Install building energy management

- Reroof 4698 sqm of premises: factory, offices with 30cm insulation

- Utilise comfort cooling and natural ventilation

- Introduced natural light harvesting

- Fit replacement high efficiency boilers

- Installation of 30Kw Solar electricity plant

- Adoption of hybrid and electric vehicles

- Smart cell automated manufacturing process – reduce faults and

waste of metals -Innovation Award Make UK

We are pleased to accept

clinical articles for publication

within the pages of

The Operating Theatre Journal

Please send for the attention of the

Editor at:

When responding to articles please quote ‘OTJ’

Find out more 02921 680068 • e-mail Issue 371 August 2021 9

Pioneering Hybrid Robotics in General Surgery

at the CHUV

Surgeons at Lausanne University Hospital (CHUV) perform the world’s first hybrid robotic general surgery. Distalmotion and

CHUV announce the launch of a clinical study. The CHUV’s Division for Visceral Surgery is at the forefront of establishing a

new standard of patient care, and will become a global reference center for hybrid robotic surgery with Dexter.

Lausanne, 16 July 2021: Distalmotion and Lausanne University Hospital

(CHUV) announced today the successful start to a case series using

Distalmotion’s surgical robot, Dexter. Prof. Dieter Hahnloser, PD Dr.

Fabian Grass and their team at the CHUV were able to carry out the

world’s first hybrid robotic colorectal procedure without complications.

Said first procedure was a rectopexy. This marks Dexter’s first clinical

use in general surgery.

Distalmotion and CHUV also announced the launch of a clinical

study. The Division for Visceral Surgery at CHUV, run by Prof. Nicolas

Demartines, Chair of the Department of Surgery, will study and evaluate

Dexter’s clinical benefits in colorectal surgery, and also provide input

in the development of procedure guidelines and training protocols for

hybrid robotic surgery with Dexter. The CHUV is thereby set to become

a global reference center for hybrid robotic surgery.

Together with select other European institutions, the CHUV has long

been the cradle of hybrid robotic surgery. From early concepts and

prototypes, to first clinical use and ensuing clinical studies, Prof.

Hahnloser and PD Dr. Grass were among the world-leading surgeons to

provide key input in the development of Dexter.

Robotics in minimally invasive care: A new approach, a new era

The traditional (non-hybrid) approach to surgical robotics forces

surgeons to choose between manual laparoscopy and robotics – forcing

them to weigh a trade-off in minimizing the perceived downsides of

foregoing either technique. Dexter corrects this false dichotomy.

Dexter surgeons can choose freely which steps of a procedure they

carry out laparoscopically, and for which steps to employ robotic aid,

thus maximizing the benefits of each technique.

Commenting on how the longstanding collaboration with Distalmotion

culminated in Dexter’s first clinical case series, Prof. Hahnloser said:

“We have come full circle, from the validation of Dexter’s hybrid

approach through countless test-runs, to launching a clinical study

where the first procedure was carried out without complications and

with the desired patient outcomes.”

PD Dr. Grass adds: “The hybrid approach overcomes prior constraints

and allows us to leverage the best of both techniques: laparoscopy and

robotics. With this approach minimally invasive surgery may become

more broadly accessible in our field.”

Prof. Hahnloser concludes: “This is a paradigm shift in how we approach

robotic surgery. The hybrid approach means surgeons remain sterile

throughout the course of an operation, thus bringing them back into the

sterile field, with direct access to their patients and teams. This also

optimizes teamwork dynamics and unlocks new training opportunities

in the OR.” The Chair of Surgery, Prof. Demartines added: “It’s the

role of academic centers to scientifically assess the benefits of new

surgical tools and techniques, and I am happy that our team fulfills this

objective very well.”

Looking forward to the continuation of the case series that will

amass more clinical evidence and help standardize Dexter procedure

protocols, Michael Friedrich, CEO of Distalmotion, reflects: “If you focus

on leveraging robotic aid where it makes most sense, then a versatile,

hybrid model like Dexter will go a long way in making surgeons’ lives

easier and ultimately produce better patient outcomes. The first Dexter

procedures confirm this and we look forward to further demonstrating

and standardizing hybrid robotic surgery through the ensuing clinical


Defining hybrid robotic surgery: from concept to clinical reality

To date, robotic aid has struggled for widespread adoption in general

surgery, despite mounting evidence for its key benefits and its

potential to help improve patient outcomes. On the other hand, certain

laparoscopic workflows have proven to be efficient and effective, and

have firmly established themselves in the OR. The idea to integrate the

advantages of both techniques – laparoscopy and robotics - therefore

resonated with Prof. Hahnloser and Dr. Grass early on, several years


Dexter in Action - First Hybrid Robotic Surgery in General Surgery

at CHUV, Lausanne. Credits: “Distalmotion & CHUV, 2021”

The Division for Visceral Surgery at the CHUV has been an integral

part of Dexter’s evolution ever since, and helped turn hybrid robotic

surgery into a clinical reality. In recent years Prof. Hahnloser and team

played an active role in exploring, qualifying – and disqualifying –

various Dexter prototypes and contributed to defining the underlying

principles of Dexter’s hybrid approach. Prof. Hahnloser shares some

reflections and outlook on Dexter’s development: “We went through an

iterative development process, where the end user – us, the surgeons –

were allowed to input from the outset. This process ended up defining

a new category of surgery and yielded a truly user-friendly robot.

In our first procedure, Dexter demonstrated his versatility and userfriendliness.

The system and all features integrated into our team’s

workflow seamlessly and quickly.”

PD Dr. Grass explains: “The concept of hybrid robotic surgery caters

to our specific needs, as surgeons, and in some sense, was conceived

to put us back in the driver’s seat. The first case quickly showed that

the Dexter system delivers on this objective, catering to our specific

requirements, being akin to the clinical realities in the OR, while

also allowing us to unfold our individual preferences and teamwork


Prof. Hahnloser also observed: “The pace at which every team member,

from our biomedical engineers, to the scrub nurses, became acquainted

and comfortable with the system points to two potential benefits of the

hybrid approach: cross disciplinary use, across teams and specialties,

and low training intensity with manageable learning curves.” Michael

Friedrich summarizes: “All signs point to hybrid robotic surgery being

accessible for a wide repertoire of procedures, fitting into OR theaters

of all sizes and being quick and easy to adopt for teams, irrespective

of previous robotics experience. On clinical and economic level this

should allow for more than one robot per institution, quite likely

multiple robots per department - a paradigm shift for most hospitals

and healthcare systems.”

Background & Contact

About Lausanne University Hospital (CHUV )

CHUV is one of Switzerland’s five university hospitals, alongside

Geneva, Bern, Basel and Zurich. It is tasked with three basic missions

by the public authorities, namely care, teaching and research. In 2020,

CHUV’s 11,942 employees cared for 48,227 inpatients, accounting for

over 456,974 days of hospitalisation. It dealt with 75,457 emergencies,

provided 1,346,973 outpatient consultations and welcomed 3,180 new

babies into the world. The Division for Visceral Surgery performs about

2,500 procedures per year. Its annual budget is 1.782 billion Swiss



Innovating through backlogs:

The NHS Future of Surgery


Go to webinar 19th October 2021

To Register for the conference

please email

Prof. Dr. med. Dieter Hahnloser at the Dexter console - First

Hybrid Ro b otic S u rger y in G e n eral S u rger y at CH UV, L au san n e.

CHUV works closely with the Faculty of Biology and Medicine of the

University of Lausanne to provide undergraduate, postgraduate and

continuing education for doctors. It also works with other higher

education institutions in the Lake Geneva area (including EPFL, ISREC,

the Ludwig Institute for Cancer Research and the University of Geneva),

with the University Hospitals of Geneva and other hospitals, health care

providers and institutions. CHUV has been ranked as one of the 10 best

hospitals in the world since 2019 according to Newsweek magazine.

About Distalmotion

Distalmotion is an international medical device company founded

and based in Lausanne, Switzerland. Our mission is to remove the

complexity out of robotic surgery in order to establish a new standard

of care, where all patients in general surgery, gynecology and urology

have access to best-in-class minimally invasive care. To do so, we

have developed a surgical robot called Dexter. Designed, developed

and manufactured in Switzerland, Dexter integrates the benefits of

laparoscopy and robotics. Dexter is the world’s first and only hybrid

surgical robot.

For further information visit: and follow us on:



When responding please quote ‘OTJ’

Credits: “Distalmotion & CHUV, 2021”

IV Summit 2021

Tuesday 5th October 2021

Mercure Sheffield St Paul’s Hotel

Free registration:

IV Summit 2021 from IVTEAM… How people, policy, product and

process are integrated into practice.

Join us at the Mercure Sheffield St Paul’s Hotel on Tuesday 5th

October 2021. Registration is free.

The IV Summit 2021 from IVTEAM will deliver a modernised conference

agenda. With our extensive online presence (which includes thousands

of weekly visitors to the IVTEAM website), we have developed a

programme based on the most read topics on IVTEAM. Our conference

agenda has been influenced by delegates for delegates.

This unique approach has resulted in content that has a direct

relationship to clinical practice. Each speaker will demonstrate how

people, policy, product and process are integrated into practice.

Programme highlights include:

• IV Training: International development and online learning: Sarah


• Clinical review of ECG PCC tip location innovation: Dave Wynne

• How to set up a nurse led implantable port insertion service:

Andrew Barton

• Interesting cases and innovative solutions for implantable port

placement: Sviatlana Vasileuskaya

• How to manage common implantable port complications: Dr Ram


• Unravelling the complexities behind IV flushing: Paul Lee

• Evaluation of sutureless securement device for children with PICCs

• Long peripheral IV catheters in clinical practice: Dave Wynne

• …Plus more

View the full programme and register for free at https://fitwise.

Get involved on social media! Use the hashtag #IVSummit21

Facebook: @ivteampage

Twitter: @ivteam

LinkedIn: in/ivteam

Find out more 02921 680068 • e-mail Issue 371 August 2021 11

Join over 500 perioperative practitioners

at AfPP’s Virtual Annual Conference

Featuring inspirational speakers, educational

sessions and virtual networking opportunities

to support your personal and professional

development. There are two educational

streams that you can switch between and

watch later on catch up.



Topics for 2021 include

Realising Your Potential

Designing the Risk Out

of Operating Theatres

AfPP launches Summer School with Incision to

Ticket prices start from £25 for Student Members & £60 for Non-members.

provide digital training opportunities for

Book now at

perioperative practitioners



Human Factors

Keynote Speakers

Dr Phil Hammond

Corinne Hutton

Prof Jean White

The Association for Perioperative Practice is a registered charity number 1118444 and a company limited by guarantee,

registered in England number 6035633. AfPP Ltd is a wholly owned subsidiary company, registered in England number

3102102. AfPP, Daisy Ayris House, 42 Freemans Way, Harrogate HG3 1DH T: 01423 881300 F: 01423 880997 W:






*Two-day ticket includes 12.5 hours live

plus six additional hours on catch up tv.

ealthcare Safety Investigations


• By: Communications team

• Posted on: 17 Jun 2021

Con_2021_half_page v2.indd 1 22/06/2021 12:56:40

Healthcare Safety Investigations



Date: 16 September 2021

Time: 10:00 – 15:30


The Association for Perioperative Practice (AfPP) and Incision are

pleased to announce their partnership to support the ongoing education

The Association for Perioperative Practice (AfPP) and Incision are pleased to announce their

and training of all AfPP members. In this educational collaboration,

partnership the full to Incision support the Academy ongoing education will be and made training available of all AfPP exclusively members. In to this AfPP

members throughout July, August and September. There are over 500







full Incision






be made







AfPP within members perioperative throughout July, practice. August and September. There are over 500 high-quality

video CEO courses of the designed AfPP, to Dawn enhance Stott skills said, and knowledge “The pandemic within perioperative has had a practice. significant

impact on training for perioperative practitioners. University courses

were postponed or shifted to remote learning, placements were

cancelled, and many of our members were redeployed from theatres

to the ICU. The AfPP works to enhance skills and knowledge within

perioperative care – ongoing education is a huge part of achieving this.

So, we are delighted to offer our members an online learning platform

they can use on their own schedule this summer. It is great to see

new methods of knowledge transfer emerging and we hope a more

virtual training format will empower practitioners to manage their own


CEO of Incision, Mr. Ritsaart van Montfrans, “We are proud to join

forces in this collaboration to support professionals working in the

perioperative field. We will keep identifying opportunities for improving

training through the application of technology, turning around the

current position of demand having to adapt to supply. So, wether AfPP

members are exploring training opportunities or are interested in a

specific course this summer, there are resources to support everyone

who works in the perioperative environment.”

We would like you to join us for our second

• By: Communications team

Healthcare Safety

• Posted on: 17 Jun 2021

Investigations Conference this September. Healthcare Safety Investigations

We have an exciting programme lined Date: up. 16 September This 2021 year we will:

Time: 10:00 – 15:30

• share the learning from our investigations, and the positive


impact that recommendations have been having on healthcare

and patient safety across the country

• find out more about how we are teaching investigation science

• guide you through the principles which sit behind modern

healthcare safety investigations

• take a close look at safety management systems. How they’re

used in other organisations, and could they work in the NHS?

• focus on how together we can make maternity care safer

• share case studies and patient stories from across our


Register now-

ealthcare Safety Investigations



By signing up you will receive occasional updates about the

conference in the run up to the event.

About Incision:

Incision is a platform for surgical performance and online training,

founded in Amsterdam by Prof. Dr. Theo Wiggers and various other

entrepreneurial professionals, on a mission to improve surgical care.

Incision’s team of medical doctors believes in sharing surgical skills and

making high-quality surgical knowledge accessible to everyone.

Further information contact: Kim Taylor


the early signs and enable them to act, Health Education England’s new

education and training materials will be particularly relevant as will a

clinical network approach to care where professionals and organisations

work together across a dened geographical area – this helps to bring

a safe, standardised and equitable approach to care.

NHS in Gateshead to make

“As a college, we have updated the national template for the Personal

Child Health Record FFP3 to include information masks for parents on how to tell

if your child is ill, and for health professionals, have recently launched

Paediatric Care Online (PCO-UK) – an online decision support tool,

providing specialist diagnostic advice to help ensure children get the

right treatment at the earliest opportunity.

“To support this, I now urge paediatricians and all healthcare

professionals to utilise the resources Sir Bruce has outlined. Collectively

we can slow down the grip of this deadly disease and reduce the number

of children who come face to face with it.”

QE Facilities Ltd is leading the way to become the first NHS body in the

country to start to manufacture FFP3 masks.

Louise Silverton, Director for Midwifery at the Royal College of

Midwives, FFP3 (Filtering said: Face “Severe Piece sepsis 3) masks can and have does become kill. Though well-known it is rare, during it

can the covid be catastrophic pandemic, for yet pregnant have been and used postnatal in the NHS women. for years to protect

staff against fine particles and airborne viruses and prevent the spread

to others. They are used in all clinical and non-clinical settings.

“Sepsis remains a leading cause of maternal death. That is why it is so

important QE Facilities that Ltd we is do the all wholly we can owned to identify subsidiary it as soon company as possible of Gateshead so that

it Health can be NHS treated. Foundation It is also Trust, important based in not the to North forget East newborn of England. babies who

can succumb to infection very quickly.

Anthony Robson, managing director for QE Facilities said: “We started

to look at how we could produce our own high-quality masks during the

“Midwives pandemic when should the certainly need for “think them sepsis” became where greater. there It’s is taken deterioration us a lot

in of the hard health work and of either investment mother to or get baby. to this This stage. means we need the right

number of midwives so that they can deliver the best possible care,

including “We have in invested the postnatal in state-of-the-art period. machinery from Germany and our

teams have undergone training to run and manufacture these masks.

Every part and stage has had to be precision-engineered to make sure


that these






the standard

of staff will



are effective

help to ensure

at filtration.


of care and carer for women. Midwives who know the woman will be

better “Our FFP3 equipped mask has to spot four changes layers, one in the of which woman’s is an condition anti-viral and layer, identify which

problems has been such proven as to sepsis kill covid developing.” on contact and is also non-allergenic. On

completion the masks are individually packed and are UV-sterilised.”

These masks are currently going through testing by the British Standards

Find out more 02921 680068 • e-mail Issue 316 January 2017 7

Laboratory and will be certified by the end of August.

Anthony continues, “It’s great to finally see these masks produced by

the NHS, for the NHS.”

The FFP3 masks have been produced with comfort and protection

in mind and have involved staff from the Queen Elizabeth Hospital

in Gateshead in the process. Ruky Talawila, one of the consultants

involved in the design process, commented:

“Staff will often wear these masks for their full shifts and more often

than not, they can be uncomfortable. It was great to be involved in this

process and as a team, we had lots of input into the design of these

masks to ensure compliance and comfort with maximum protection.”

“The mask will include a headband rather than the standard straps and

have also been designed to fit better on our face which will be a much

more comfortable fit.”

“We’re also looking at a plastic nose piece so that NHS radiology staff

can still wear our FFP3 masks when using the MRI machine.”

Each mask is individually fitted to staff members to achieve good

contact between the skin and the face seal of the mask. Each mask

fits slightly differently to an individual’s face as this is the only way to

ensure protection.

Working in partnership with Northumbria Healthcare NHS Foundation

Trust, the masks are being made in Plant Based Valley, in Seaton

Delaval, Blyth Valley and forms part of the North East NHS’s desire to

produce high-quality PPE locally.

Sarah Rose, divisional director of the Northumbria Healthcare

Manufacturing and Innovation Hub said: “At the start of the pandemic

we learnt very quickly that to protect our workforce, we needed to

secure a local supply of PPE. Northumbria Healthcare NHS Foundation

Trust purchased a large-scale production space in the locality, with

an ambition to eventually share the opportunity with neighbouring

trusts and partners. The production of FFP3 masks has been an ongoing

project with QE Facilities Ltd, and I am pleased to see the install of the

machine has been a success. Tens of thousands of healthcare staff will

benefit from this move, not to mention those in the private sector as

production grows.”

Once up and running, QE Facilities Ltd will be able to produce 18 masks

every minute and discussions are ongoing for contracts in both the

public and private sectors.

to other common illnesses, and the College is putting a lot of effort

into helping family doctors recognise potential sepsis and ensure that

patients rapidly receive appropriate assessment and treatment.

“We have produced a toolkit, in partnership with NHS England, which

brings together existing guidance, training materials and patient

information to encourage us all to ‘think sepsis, talk sepsis and treat


“We are pleased to be working with NHS England to raise awareness

and improve outcomes for patients. It really could save lives.”

Anna Crossley, Professional Lead for Acute, Emergency & Critical

Care at the RCN, said: “Sepsis is a life-threatening condition and early

identication is the key to survival, but it can be difcult to diagnose

and often symptoms can be mistaken for a u-like illness. This is why

raising awareness among carers, health care professionals and the

public is so vital. Even though there has been good progress to improve

diagnosis, a cohesive national plan is needed to ensure that healthcare

professionals are supported and equipped to identify and treat sepsis


“If sepsis is not recognised quickly, it can lead to shock, multiple organ

failure and death, which is why early detection is critical to start

treatment within the hour. Nurses and health care support workers,

who see their patients on a regular basis, and are often the rst

healthcare worker to see them, are well placed to recognise the signs

of sepsis early and raise the alarm. If a person has signs or symptoms

that indicate possible infection, think ‘could this be sepsis?’ and act

fast to raise the alarm, wherever you are.


Find out more 02921 680068 • e-mail Issue 371 August 2021 13

Owen takes on

triathlon challenge

for cause close

to his heart

DP Medical’s commercial

director, Owen Pemberton,

has completed his first ever

triathlon in aid of a charity

that has provided a wealth of

support to his family.

Owen took on the sporting

challenge at Dorney Lakes

in Buckinghamshire to raise

funds for The Schinzel-Giedion

Syndrome Foundation.

Owen’s nephew Jude is one of

only 50 children in the world

with Schinzel-Giedion Sydrome

(SGS), an ultra-rare life-limiting

neurodegenerative condition

that means he cannot walk, talk

or eat as a normal child would.

He has daily seizures and is

fed via a feeding tube, battling

many problems daily in order to

live a comfortable life.

Owen, who took on the

challenge as part of a team

raising money to celebrate

Jude’s third birthday, said: “July

marks Jude’s third birthday - a

huge milestone because children

with SGS are not expected to

live beyond infancy.

“To celebrate, we came up with

the “July For Jude” challenge

to run/cycle/skip/jump/swim 1

mile every day in July. It’s not

about the distance. It’s about

the unrelenting commitment to

doing something difficult every

single day - which reflects the

huge responsibility a parent

must undertake when caring for

a seriously disabled child with


“Taking on the triathlon was

part of the July for Jude

activity and, despite having no

experience of ever competing

in multi-disciplinary sporting

events, I’m proud to say I

completed the 750m swim,

20km bike ride and 5km run –

and even beat my target time

by almost ten minutes!

“All money donated will be

used by The SGS Foundation

to support children with SGS

and their families by ensuring

they are connected and have

the knowledge and information

they need to make empowered

decisions about their child’s


The SGS Foundation exists to

provide support for families

caring for a child with SGS, to

raise awareness of SGS and to

facilitate and support medical


For further information about

the charity, visit:

You can support Owen and his

family’s fundraising for the SGS

Foundation by donating here:


Your new career is here...

Join our Medirooms

Other offerings:

A new concept in healthcare, our Medirooms combine the traditional recovery, day-case, same-day and

admission areas into a single patient room environment, specifically designed to enhance patient

experience by improving the level of privacy and dignity that these areas were traditionally able to offer.



A bespoke orientation day

composed of a tour and

presentations to help new starters

understand the

Medirooms/Theatres patient flow,

documentation and IT system.

Relevant COVID19 topics are

discussed in accordance with

Public Health England’s guidelines.

Recent departmental audit showed

that new starters feel more

prepared and supported.




A participatory learning approach,

promoting a shared learning

environment and collaborative

working in Medirooms, these extra

teaching sessions encourage the

sharing of knowledge, skills, pearls

of wisdom and experience to the

rest of the team.



A notice board, accessible by

everyone whereby; upcoming

training dates are posted, new

starter information, contains

important NMC announcement,

Student-related information, and

information about staff-wellbeing.

This "board" is helpful as form of

communication especially to staff

who may not necessarily able to

check their emails regularly.

For further information email:

New staff reflective gardens and free

media services for patients at UHNM

Patients at the University Hospitals of North Midlands

NHS Trust can access free media services, and staff

can now spend breaks in a reflective garden with

a ‘memory tree’, paid for by the trust’s charity.

Awareness of the charity and its aims are being

promoted on the homepage of the SPARK Media

platform by WiFi SPARK.

Reflective gardens with a ‘memory tree’ containing

the names of colleagues and loved ones who have

died during the past year have been created by the

University Hospitals of North Midlands NHS Trust

(UHNM). Both the Royal Stoke University Hospital,

in Stoke-on-Trent, and County Hospital, in Stafford,

now have gardens where staff can spend breaks in

quiet contemplation. Five staff members have died in

past 12 months – four due to Covid-19; their names

and those of relatives who have also died, have been

engraved on the metal trees.

Lisa Thomson, director of communications and charity

at UHNM, said: “The coronavirus pandemic has been

continually stressful every day for more than a year,

for patients, their families and our staff. UHNM’s

charity has been well-supported through the goodwill

of the public, so we wanted to use some funds to

help make things a little easier for everyone who

stays, visits or works here. The memory trees in the

reflective gardens will hopefully bring some comfort

to staff as they remember colleagues and loved ones.”

The charity is also funding free online entertainment

and media services for patients via the SPARK Media

platform provided by WiFi SPARK. Services such as

TV, radio, films, games, newspapers, magazines, and

access to NHS videos and therapy apps, will also be

available on phones and tablets, when the platform

goes live in the coming weeks. The new installation

of the SPARK Media platform follows the successful

roll-out of WiFi in the trust, by WiFi SPARK in 2020;

WiFi and entertainment services are free of charge

for patients, visitors and staff, and are fully supported

with a 24/7/365 service desk.

“We know that during the pandemic, patients have

suffered greatly from having little or no contact

with their families and friends, so being able to

speak to them via video calls is a boost to morale,”

said Thomson. “By providing free WiFi and now

with new media services being made available,

these entertainment options can help pass the

time in hospital and aid patient recovery.”

The SPARK Media platform can be customised to a

trust’s requirements, and for UHNM, a link to its

charity is found on the homepage. The charity has

other initiatives it provides for patients and staff,

including screens on the ceilings of its critical care

and radiology units, which play sky scenes.

“There are no windows in these wards and so there

is no natural light,” added Thomson. “Having sky

scenes playing with sunshine and rolling clouds

emulates daylight and can help prevent delirium

in patients, and it provides a nicer working

environment for staff as well.”

Gaining support for the charity via the SPARK

Media platform will help it to continue to provide

services and initiatives to improve patients’

experiences and staff wellbeing.

Dean Moody, chief commercial officer at WiFi

SPARK, said: “Charities are an invaluable part of

NHS trusts, and UHNM’s is providing some great

ideas for patients and staff. The past year has been

incredibly difficult for many people, so any services

that aid patient recovery or make staff working

conditions a bit easier have to be welcomed. We

are pleased to be part of that philosophy at UHNM.”

WiFi SPARK is a leading provider of commercial

WiFi and media services to the healthcare, retail,

transport, sport and exhibition space sectors. The

company works with nearly 300 hospitals across

more than 80 NHS trusts and health boards in the

UK. It provides 24/7 support to customers.


A one-stop resource for ALL your theatre related Career opportunities

View the latest vacancies online !

Theatre Practitioners Recovery Nurses Anaesthetic Nurses ODPs

Scrub Practitioners Nurse Practitioners Medical Representatives

and Clinical Advisers

83 AUDIT REPORT Waitematā District Health Board Annual Report 2018/19

Find out more 02921 680068 • e-mail Issue 371 August 2021 15

Augmented reality project to help train surgeons

around the world on ‘hyper-real’ models of organs

A Scottish consortium is set to use augmented reality (AR) software to

help train surgeons on hyper-real 3D-printed models of human organs.

The software will guide trainee surgeons as they perform “surgery” on

the lifelike models and will be used in the UK and less developed areas

of the world.

Project partners are working with the National Manufacturing Institute

Scotland (NMIS) to deliver the immersive technology, which will remove

barriers to training by allowing surgeons to practice vital lifesaving

skills at home.

The consortium includes industry-lead Organlike, which has produced

the models of organs, along with NHS Highland, The Royal College

of Surgeons of Edinburgh, Vivolution, KWWK Ltd, 4c Engineering and


Backed by funding from the Innovate UK Sustainable Innovation Fund,

they have already distributed 160 kits to the UK and Africa, consisting

of 3D-printed bio-synthetic organs, real surgical instruments, and a

mobile phone holder.

Accessible via a smartphone app, augmented reality technology is used

to scan physical models of organs made from hyper-realistic aqua gel,

designed to mimic the texture of human tissue. This scan generates a

digital representation of the organ, which is displayed on the trainee’s

phone and provides instructions that feedback when a procedure is

successfully completed. Trainees can also film their work for review

from experienced surgical trainers.

As well as helping train surgeons in the UK, the technology can help

medical professionals in less developed areas of the world where

training facilities are scarce or non-existent. Kits have already been

delivered to three countries in Africa, with discussions ongoing for

other territories around the globe.

The project is particularly valuable in the current climate, removing

the need for trainees to rely on classroom cadavers to perfect their

skills, a resource that has become scarce during the pandemic.

Danny McMahon, Digital and Metrology Lead at the National

Manufacturing Institute Scotland, said: “Our software works along with

Organlike’s hyper-real models to provide guidance and training, as well

as feedback on performance. While there is no replacement for the

real thing, we can help prepare trainees for taking the next step in

their training.

“Although coronavirus restrictions are lifting, we expect there to be

an increasing demand for a more flexible approach to surgical training

going forward. The application for this technology extends far beyond

Scotland and although it’s still relatively early days for the project we

are already excited about its potential.”

Professor Will Shu, founder and director of Organlike, said: “Augmented

reality is the perfect complementary technology to accompany our

models and this partnership is really exciting. With in person learning

limited by restrictions on access to facilities and resources, this

technology could help trainee surgeons who can’t currently access

facilities to work in their own space. Our hope is that our product

will form an important part of future training programmes across the


Professor Angus Watson, Member of the Council of The Royal College of

Surgeons of Edinburgh, said: “Surgical simulation represents the future

for our profession. The public expect us to uphold the highest standards

of surgical skill and care and the College has been at the forefront

of this for over 500 years. I am particularly proud that we can make

training opportunities equitable across the globe and I am delighted

that this kit will be available both in Scotland and in Africa.”

The Royal Marsden Adult

Palliative Care Virtual


Explore new trends and ideas

surrounding palliative care issues

Wednesday 3 and Thursday 4 November 2021



Congratulations, you are now reading, the extended OTJ

The Operating Theatre Journal

Discovering the many more pages available online @

Technology investment will transform global healthcare

away from an illness service

Healthcare must become a genuine health service, not an illness

service, according to Robert Stern, chairman of digital health champion

Future Perfect.

It was currently too reactive instead of preventive, he argued further

in an article for the influential multi-media Health Tech Digital outlet:

“The journey a patient takes is, in theory, a simple, step-by-step

process. When no more care is needed, the journey ends – until the

next problem arises.

“It waits for problems to appear before action is taken. It doesn’t make

use of the active, digitally enabled patient.”

Stern advocates a two-prong approach to creating a preventive

healthcare system: empowering the patient to prevent illness and then

breaking down barriers to prevention over cure.

He urges increased use of healthcare apps to empower patients while

integrating them with patient journey records. With patients managing

their own care, problems could be spotted sooner, helping to avoid

crisis while giving patients greater access to their GPs and specialists.

“These apps could become a staple part of the patient journey that

often traverses beyond the pathway of any one particular condition.

This would allow both patient and clinicians to have a view of the

patient’s history to date and, also, keep an eye on the future,” he


Stern also wants interconnected electronic records tracking a patient’s

complete healthcare history and journey through the system – past,

present, and future:

“Person-based illness prevention is already known to be ‘investible’

and pursuing prevention by leveraging joined-up records could offer so

much more.”

But Stern stresses that investment is critical:

“Take public healthcare and apply it to person-based illness prevention.

Organise and synergise existing collection systems and apply the data

to the person. It changes the dynamic of the patient journey from being

focused on the extremes of acute illness to being about health – the

whole cycle.”

“There are so many examples you can think of where this might work,

from asthma to diabetes, and we need investment in this area to make

it happen.”

World Nano Foundation chairman Paul Sheedy agrees strongly with

Stern that investment into healthtech and nanomedicines has to be

accelerated, as we cannot afford the hugely inefficient centralised

healthcare systems that we have. We have to move to a point of care

model that supports early intervention and protection:

“A prevention-based healthcare system would drastically reduce

healthcare costs, prevent suffering for many individuals, and free up

time for healthcare professionals to save more lives. The benefits are

undeniable – we simply must invest.

“We need to back emerging therapies too. No healthcare system can

completely prevent illness, so we need the best treatments available

to us when needed. Investing in therapies will help to create more

accessible, portable treatments, further decentralising healthcare


Paul Stannard a general partner of the Vector Innovation Fund, which

recently launched a sub-fund raising an initial $300m for future

healthcare, as well as pandemic protection and preparedness, focusing

on precision medicine, advanced point of care, early intervention

diagnostics and AI technologies that support sustainable healthcare,

the global economy, and human longevity.

“Over 50% of the world’s healthcare budgets go on putting a sticky

plaster on people’s health, but most of it is spent on the last six weeks

of our lives, essentially end of life care, which cannot be the best

model for a healthy world. We have been tracking these advanced

technologies for five years and are seeing huge potential upsides for

global health, which will deliver much more affordable and accessible

technology solutions that deliver better outcomes and, ultimately, a

more sustainable healthcare ecosystem.

“The recent pandemic has profoundly highlighted that early intervention

is key to solving the biggest health challenges we face and moving to a

more decentralised model based on technology investment is the key

to sustainable health and improving life longevity.”

Find out more 02921 680068 • e-mail Issue 371 August 2021 17

FAST-FIX FLEX Meniscal Repair System, the only device to offer a surgeon-guided

bendable needle and shaft providing access to all zones of the meniscus. Improving a

leads Smith+Nephew to a greater launches opportunity the FAST-FIX to repair FLEX the meniscus Meniscal rather Repair than System; remove extends it, resulting allinside

repair possibilities with 1-3, 13-15


term benefits to the patient. greater access across all zones of the meniscus*

Smith+Nephew the global medical technology business, recently announced the launch of its FAST-FIX FLEX Meniscal Repair System, the only

device to offer a surgeon-guided, bendable needle and shaft providing access to all zones of the meniscus. Improving access leads to a greater

opportunity to repair the meniscus rather than remove it, resulting in long-term benefits to the patient.1-3, 13-15

Smith+Nephew's Smith+Nephew’s FAST-FIX FLEX FAST-FIX Meniscal Repair System FLEX Meniscal Repair System

Building on the 15-year clinical legacy of its FAST-FIX platform, Smith+Nephew’s new FAST-FIX FLEX system uses an all-inside approach which may

eliminate the need for further incisions, reduce the risk of neurovascular injury, and provide procedural efficiency to support faster operating

times.4 The added ability to bend both the needle and shaft enables surgeons access to the mid-body and anterior zones, inaccessible by previous

FAST-FIX devices. These meniscal zones account for more than 40% of tears in stable adult knees1,2,5 or roughly 400,000 procedures, (meniscal

repairs and meniscectomies) per year in the US alone.6

Dr. Jeffrey Klauser, Connecticut Orthopaedics commented, “FAST-FIX FLEX is a patient and surgeon friendly device that simplifies the all-inside

approach. The ability to personalize the degree of curvature to the patient’s tear pattern eliminates the need to change portals or utilize multiple

techniques while preserving meniscal tissue during repair.”

With one of the smallest needles in the all-inside device category and smooth, low-profile anchors, FAST-FIX FLEX offers a 25% reduction in needle

insertion area as well as a repair that is more than 20% stronger than the previous generation FAST-FIX 360 System.**7,8

“FAST-FIX FLEX will revolutionize the all-inside meniscal repair device segment,” said Dr. Jorge Chahla, Midwest Orthopaedics at Rush, Chicago IL.

“Delivering characteristics of FAST-FIX 360, the gold standard in meniscal repair, FLEX adds new features enabling surgeons to address previously

inaccessible tears through the quick and reproducible all-inside approach; while improving upon the tried and true technique.”

Meniscal tears continue to be one of the most common orthopaedic injuries.9 To treat this injury, most patients receive a partial meniscectomy or

a complete removal of the meniscus6,10,11 shown to significantly increase the risk of osteoarthritis and the rate to total knee replacement.12,13,14

Alternatively, meniscal repair, has been shown to slow the progression of osteoarthritis which may facilitate a quicker return to normal knee

function post injury.13,14,15

“The launch of FAST-FIX FLEX represents a new milestone in meniscal repair, and we are truly delighted to provide this technology to surgeons

across the globe,” commented Christie Van Geffen, Vice President Global Marketing, Joint Repair, Smith+Nephew. “Its addition to our All Tears, All

Repairs Meniscal Repair Solutions portfolio will accelerate our goal to change the standard of care away from meniscectomy and toward meniscal


The FAST-FIX FLEX Meniscal Repair System is commercially available for sale in the US and select countries across the globe. For more information,

please visit:

*As compared to predicate device

**As demonstrated in biomechanical testing


Smith+Nephew launches the FAST-

FIX FLEX Meniscal Repair

System; extends all-inside repair

possibilities with greater access

across all zones of the meniscus*

Smith+Nephew the global medical technology business, recently announced the launch of its

1. Smith+Nephew 2021.Validation, FAST-FIX FLEX. Internal Report. 15010267 Rev A.

2. Smith+Nephew 2021.Validation, FAST-FIX FLEX. Attachment B. Internal Report. 15010267 Rev A.

3. Smith+Nephew 2021.FAST-FIX


FLEX- Surgeon Surveys.


Internal Memo.

Repair System, the only device to offer a surgeon-guided,

4. Karia M, Youssef G, Al-Hadithy N, Mordecai S, Gupte C. Current concepts in the techniques, indications and outcomes of meniscal tears. Eur J Orthop Surg Traumatol. 2019;29(3):509-520.

bendable needle and shaft providing access to all zones of the meniscus. Improving access

5. Metcalf MH, Barrett GR. Prospective evaluation of 1485 meniscal tear patterns in patients with stable knees. Am J Sports Med. 2004;32(3):675-680.

6. 2020 SmartTRAK US Meniscal Repair Fixation market report.

leads to a greater opportunity to repair the meniscus rather than remove it, resulting in longterm

benefits to the patient.

7. Smith+Nephew 2021. Competitive, FAST-FIX FLEX Dimensional Analysis. Internal Report. 15010919 Rev A.

8. Smith+Nephew 2020. Biomechanical Testing, FAST-FIX FLEX. Internal 1-3, Report. 13-15 15010180 Rev A.

9. Mordecai SC, Al-Hadithy N, Ware HE, Gupte CM. Treatment of meniscal tears: An evidence based approach. World Journal of Orthopedics 2014;5(3):233-241.

10. Abrams GD, Frank RM, Gupta AK, Harris JD, McCormick FM, Cole BJ. Trends in Meniscus Repair and Meniscectomy in the United States, 2005-2011. AJSM 2013;41(10):2333-9.

11. Katano H, Koga H, Ozeki N, et al. Trends in isolated meniscus repair and meniscectomy in Japan, 2011-2016, Int. J. Orthop Sci. 2018;23(4):678-81.

12. Papalia R, Del AD, Osti L, Denaro V. Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. British Medical Bulletin. 2011;99:89-106.

13. Pengas IP, Assiotis A, Nash W. et al. Total Meniscectomy in Adolescents: A 40 Year Follow-up. JBJS 2012;94-B:1649-54

14. Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jäger A. Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal

tears. Am J Sports Med. 2010;38(8):1542-1548

15. Lee, WQ, Gan JZW, Lie, TTD. Save the meniscus- Clinical outcomes of meniscectomy versus meniscal repair. Journal of Orthopaedic Surgery. 2019;27(2):1-6.


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World-leading study to pitch human skill against robot

for knee surgery

A new £1.6 million NIHR-funded study will

compare the benefits of knee replacement

surgery performed using a robot to a surgeon

using traditional methods.

Knee replacements are common operations,

with over 100,000 procedures performed

each year in the UK. The RACER (Robotic

Arthroplasty: a Clinical and cost Effectiveness

Randomised controlled trial) study will

compare the use of surgical robots to standard

instruments in an effort to determine which

of the two techniques is best at improving

patient outcomes and reducing pain following


The study will be jointly run between University

Hospitals Coventry and Warwickshire (UHCW)

NHS Trust, Warwick Medical School at

the University of Warwick, and the Royal

Orthopaedic Hospital (ROH) in Birmingham.

Equal numbers of participants will be

randomised to each treatment group to find

out which surgical technique results in better

outcomes. This will include asking questions

about people’s ability to complete activities

and their quality of life in the long-term and

will also find out which method provides the

best value for the NHS.

The surgeon will perform the operation for

both options in the study. They normally use

instruments that provide pre-set angles to help

them do the operation, but some surgeons

have started using a robotic arm attached to a

computer with a pre-prepared map of the leg

to guide them.

Surgical robots are favoured by some for

their precision and guidance, while standard

instruments are preferred by others for their

simplicity and ability to use surgeons’ skills

and experience, without the added expense.

The team will invite patients to take part from

six NHS hospitals across England and Scotland

over the coming months. The company that

makes the robot, Stryker, will be supporting

the study with costs to ensure hospitals do not

have to pay extra to take part.

The study is being led by two surgeons, Mr Andy

Metcalfe, from UHCW and Warwick Clinical

Trials Unit at the University of Warwick, and

Professor Ed Davis, from ROH.

Mr Metcalfe, said: “Can robots help surgeons

perform knee replacements better? This is a

really important question and we’re delighted

that the NIHR has agreed to support the study.

“Surgeons are always working to improve the

care we give and we’re seeing more robots in

surgery now. This study is about whether using

a robot gives better results for patients having

knee replacements and we’re looking forward

to being able to answer that.

“It is a big achievement for the team to be at

the forefront of a world-leading multi-centre

study like this, it is probably one of the most

important questions in orthopaedic surgery

right now. We’re really pleased to be able to

get started.”

Professor Ed Davis added: “We are excited to

begin this incredibly significant study.

It will help orthopaedic surgeons across the

world to better understand the most effective

tools and techniques when performing knee

replacements. It will also help us to ensure

patients enjoy the very best outcomes.

“The team have all worked incredibly hard

during the pandemic to ensure this trial is

safe and of the highest quality. We are all very

keen to evaluate the evidence and share it as

widely as possible.”

Although the trial opened at the end of

December 2020, activity was delayed by the

Covid-19 response, when most orthopaedic

services were paused. Some hospitals are now

seeing patients again and the study is now

accepting patients into its first sites.

The Royal Orthopaedic Hospital in Birmingham

and the Royal National Orthopaedic Hospital

in Stanmore, London, are already open for

recruitment, with a number of other hospitals

across the UK (including the Glasgow Royal

Infirmary, the Royal Infirmary of Edinburgh,

the Freeman Hospital in Newcastle, the Royal

Devon and Exeter NHS Trust, and Portsmouth

NHS Hospitals) expected to open soon.

More information about this study is available

on our Funding and Awards website.:


Interventional Approaches for

Cancer Related Pain & Acute

Pain and Persistent Post-

Surgical Pain Conference

Defining the role of interventional

approaches in the treatment of cancer pain

Thursday 16 and Friday 17 December 2021



Pennine Acute Hospitals NHS Trust invests £5m to upgrade

IT infrastructure, refreshing its EUC estate using IGEL

…The use of IGEL OS results in the Trust saving £500k not buying new desktops…

IGEL, provider of the next gen edge OS for cloud workspaces, announces today that Pennine Acute Hospitals NHS Trust has updated its end-user

computing (EUC) environment, implementing IGEL OS and UD3 endpoints throughout the organisation.

This is part of a £5 million investment the Trust is making to replace and refresh its entire IT infrastructure including compute, storage, WAN/

LAN network and thin client platforms. This significant upgrade project is putting in place modern, class-leading technology to support the Trust,

provide high quality clinical care and services for around 820,000 local residents.

Located in the Northeast of Manchester, Pennine Acute Hospitals serves the communities of Bury, Rochdale and Oldham along with surrounding

towns and villages. Employing 10,000 staff, it operates four hospitals: Fairfield General Hospital, North Manchester General Hospital, Royal

Oldham Hospital and Rochdale Infirmary.

As part of the overall project, the necessity to change the EUC platform was pressing. Pennine Acute Hospital’s existing thin client solution was

already a decade old, over 2,000 hardware devices were end-of-life and no longer supported; and it had a requirement to expand the use of virtual

desktop infrastructure (VDI) and thin clients across the organisation. To complicate matters, the devices couldn’t be centrally or easily controlled

because the server-based management software was not up-to-date.

Jav Yaqub, the Trust’s head of infrastructure, explains, “The upshot was we were consuming a huge amount of time trying to maintain and run

our thin client desktops, with major platform mismatches hindering our ability to roll out new operating systems like Windows 10 or deploy Office

365, which was crucial as NHS Digital has mandated that Windows 7 be removed from all desktops. ”

After a successful trial, the decision was made to select IGEL for the new EUC solution. In tandem, the Trust updated its entire compute systems

in its datacentre installing a Dell EMC VxRail hyperconverged infrastructure platform as well as Dell EMC network attached Isilon, Data Domain

and ECS storage.

The new VxRail compute platform is also used to host VMware Horizon – the Trust’s VDI solution – with 3,000 IGEL OS licenses and 500 new IGEL

UD3 endpoints purchased, along with IGEL’s management software, the Universal Management Suite (UMS). IGEL Cloud Gateway was acquired

to centrally manage endpoints not on the corporate network. Furthermore, NVIDIA virtual GPU technology is being trailed within the VxRail

environment to share graphics power and capability across the VDI estate.

IGEL OS deliver significant operational and financial advantages

The move to IGEL OS and UD3 thin client endpoints is already delivering substantial benefits:

• Budget saved. £500,000 has been saved as the Trust has avoided buying 2,000 new thin client devices for the organisation.Despite being told

they were end-of-life, many of the old endpoints from the previous incumbent supplier have been recycled - converted using the IGEL OS into

centrally controlled devices. Yaqub says, “For the flexibility and portability the IGEL OS offers which is a key reason for our purchase, the costs

are reasonable and IGEL are competitive with their pricing.”

• Reliability improved. Most thin client devices at the Trust are used at workstations in hospital wards and on 100 laptop trollies which nurses and

other health professionals use in various clinical settings. IGEL OS has vastly improved the reliability and performance of these trolly machines

given that IGEL OS is much ‘lighter’ - at 1GB – rather than the Windows OS which is typically 16 GB in size.

• Implementation simple . Roll out was easy and fast with the Trust supported by third party consultants who helped install IGEL OS and convert

devices – a re-flashing process which took just minutes. Yaqub says, “It was very much a non-event. It was easy, with no significant problems,

as IGEL support has been excellent.”

• Management straightforward. Using IGEL’s Universal Management Suite (UMS) makes the day-to-day management of the whole estate of 2,000

thin clients located across four geographically dispersed hospital sites really straightforward. Just one person now handles this for the whole

organisation as part of their overall job role. IGEL specific training was provided allowing policies and security settings to be created and pushed

out automatically to all devices.

• The local care ecosystem joined up. The Trust has also connected five local community care providers to its VDI environment. They use an

IGEL-OS powered endpoint to view its electronic patient records (EPR) system. Partners access the EPR via VMware Horizon – with IGEL Cloud

Gateway used to manage remote devices - so that patient care is available anywhere across the local community.

• Remote work capability delivered quickly in light of Covid. The Trust has been able to easily ramp up remote access capability to empower staff

to work from home during the Coronavirus pandemic. Prior to the COVID-19 outbreak, 600-700 staff did so but this was increased to 3,000 in just

three weeks. Staff login to their VDI session via a standard browser which takes them to their Trust branded Windows 10 desktop. Imprivata is

used to enabled single sign-on to specific applications.

Yaqub says, “The infrastructure update project has been hard work. We’ve done about four years work in just two with staff now commenting that

they’ve seen big improvements in system performance, speed, flexibility and the IT teams’ ability to deliver. This makes all the graft worthwhile

and rewarding, and IGEL has played an important part in enabling this.”

Moving forward, Pennine Acute Trust is reviewing how it can increase the scope of VDI and thin client usage within the organisation. Using the

IGEL OS, the goal is to convert more desktop devices in other departments like estates and finance into locked down, centrally controlled and

secure endpoints.

The IT team is also working on a proof of concept within the radiology specialty to capitalise on the graphics capability of the new backend

infrastructure. This could allow radiologists working internationally to access its systems using VDI and powerful multimedia IGEL endpoints -

rather than expensive laptops being provided - to review and study MRI and X-ray scans to aid with patient illness diagnosis and treatment.

Simon Townsend, IGEL’s chief marketing officer says, “Ultimately technology in the health service is all about delivering better patient care. As

an IT provider, we have our part to play in this so that clinicians and other health professionals have high performance, reliable desktop solutions

offering them the very best user experience. That’s what the IGEL OS running on any endpoint hardware is designed to do.”

IGEL on Social Media





IGEL Community:

When responding to articles please quote ‘OTJ’

Find out more 02921 680068 • e-mail Issue 371 August 2021 21

James Cook University Hospital becomes the first hospital in the North

of England to install ORBEYE, allowing neurosurgeons to operate in 3D.

A revolutionary robotic exoscope which allows surgeons unprecedented

4K-3D views of the brain and spine during surgery has been installed at

The James Cook University Hospital in Middlesbrough.

The exoscope, named ORBEYE, allows surgeons to become untethered

from traditional ocular microscopes and instead operate from a

55” monitor in real-time. The technology has extremely powerful

magnification and coupled with natural 3-dimensional technology,

ORBEYE allows surgeons to see the finest of anatomical structures in

deep parts of the brain.

Normally, a surgeon would use a traditional microscope to see fine

anatomical details, often enduring hours in uncomfortable positions

looking down into the eyepieces. This is a big problem, as surgeons

go onto develop working-musculoskeletal disorders which can often

increase fatigue during surgery and reduce operating career-length.

Instead, using ORBEYE surgeons can access these same areas but

instead look straight ahead at the large 3D monitor.

For patients, being operated on by ORBEYE means surgical incisions

are potentially smaller, therefore resulting in a shorter stay in hospital,

quicker recover time and lower risk of infection.

James Cook the second NHS centre to benefit from revolutionary exoscope

ORBEYE represents a first step into the digitisation of neurosurgical

imaging. This will mean in the near-future, optimising technologies such

as artificial intelligence will be able to be incorporated into ORBEYE

and used to accelerate beneficial patient outcomes in microsurgery.

A significant step forward

The ORBEYE represents a significant step forward in neurosurgical

imaging for James Cook Neurosurgery Department as a result of its

state-of-the-art new exoscope with 4K-3D views of the brain and spine

during surgery. In layman terms, an exoscope is a hybrid between the

conventional operating microscope and endoscope.

Unlike some traditional microscopes which exclude the team from

viewing the surgery, ORBEYE allows the wider medical team to see

exactly what the surgeon is seeing in real-time, facilitating clinical

discussions between clinicians and making ORBEYE a great teaching

tool for the next generation of neurosurgeons.

Head Medical’s Theatre Division was launched in February 2019.

We specialise in the recruitment of Theatre RNs and ODPs for

the NHS and private hospitals, covering scrub, anaesthetics and

recovery shifts.

Our Recruitment Consultants have over twenty years of combined

experience looking after theatres. Our two Nurse Managers have

worked in operating theatres themselves and are here to support

you with free training, appraisals and guidance through your NMC


We started with one ODP working in a hospital in the West of

Scotland, and now have over 120 candidates working across the

country. We can offer full time block bookings and ad hoc shifts at

competitive pay rates. Our friendly team will help you through the

registration process and then match you to your ideal assignment.

We need more people to join our team and become part of our

community. If you are an ODP or RN who is registered with either

the NMC or HCPC and eligible to work in the UK, we would love to

hear from you. We have a referral scheme in place too. For every

successful RN or ODP you send to us, you will receive £250.

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Clinical Director for Neurosurgery and Consultant Neurosurgeon Mr

Manjunath Prasad, said “The ORBEYE is a leap into the next generation

of technology. Although there will be a prolonged period of overlap with

the microscope, the ORBEYE exoscope provides an exciting alternative

and additional resource. The microscope we had gave just 2D images,

but with ORBEYE it displays fantastic images on a 3D screen which

makes it better for efficiency of movement and safety during some

very critical periods of surgery, thanks to the clarity of the images, less

clutter in theatre and decreased surgeon fatigue.”

Sarah Morley, Sister of Neurosurgery Main Theatres said “Middlesbrough

is the second centre in the NHS to have the privilege of using this

cutting edge technology and it gives us the reassurance as staff that we

are not being left behind and are continuing to innovate”.

Kirsty-Anne Lewis, Sister of Spinal Neurosurgery Theatre said “Firstly,

ORBEYE is really easy to set-up, there is less clutter and it’s a smaller

footprint. It provides an unobstructed view in theatre for everybody

and it’s better visibility of the operating field real-time which makes

us feel safer”.

Nathan Hooker, National Sales Consultant at Olympus, said “James

Cook‘s investment in ORBEYE is great for the patients of Middlesbrough

and really propels the neurosurgery department into a new era of

intraoperative imaging. I’m really pleased to see the platform so

coveted with the team here and can’t wait to begin”.

When responding to articles please quote ‘OTJ’




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Sharps Safety in Operating Rooms:

A Review of Surgical Blades

In health care, sharp instruments (or medical sharps) are any objects that can prick or cut, causing injury to the user.

This term covers such things as needles and scalpel blades, as well as glass. The nature of these tools makes unintended

injuries to health care workers an ever-present risk, especially in a surgical setting.

Sharps injuries to health care workers can occur in a variety of contexts. A sharps injury could occur in the middle of a procedure, via accidental

collision or during the disposal of a used sharp. These injuries occur most often in wards and operating theatres but also occur outside of hospitals,

at health centres, or during the administration of domestic care.

Unfortunately, despite ongoing efforts to reduce injuries, both health workers and patients remain at risk.

In this article we:

• Define sharps injuries occurrence in the operating room or theatre.

• Review percutaneous injury and the risks they present to medical teams inside operating environments.

• Outline best practices for reducing sharps injury inside the operating room.

• Review, compare and contrast the use of safety-engineered devices and how they can help combat and reduce risk inside theatre.

• Consider the Swann-Morton range of sharps safety products that can support hospital teams and reduce risks associated with medical sharps.

Sharps Injury inside Operating Rooms

In operating environments, the 2009 Exposure Prevention Information Network (EPINet) report indicated Operating Rooms accounted for 35.5% of

all sharps injuries –making it the highest category of risk, overtaking Ward based injury.

This risk is exacerbated by the nature of operating room environments, requiring multiple health care worker co-ordination in surgical procedures

– often in confined spaces and under pressurised situations.

Pooled reporting from 99 Hospital facilities reporting to Massachusetts Department of Public Health (2004) found that 33% of sharps injuries

occurred in theatre. Of these, 50% of injuries were sustained by physicians.

Technicians incurred 25% of injuries, while a further 20% affected nurses. Of injuries attributed to the Operating Room, 25% were due to collisions

with colleagues or sharps.


What are Percutaneous Injuries?


A percutaneous injury is defined as any injury that penetrates a health worker’s skin.

The risks here are elevated if the tool involved has been contaminated by a patient’s blood. This can lead to percutaneous exposure to bloodborne


The infectious risks here include Hepatitis B or C, and HIV.

In the European Union/European Economic Area (EU/EEA) approximately 9 million people are chronically infected with hepatitis B virus (HBV) or

hepatitis C virus (HCV) with a further unknown number of undiagnosed cases. (1)

This risk also relates to patients. The NHS Hepatitis C Infected Health Care Workers guide states that there were five incidents in which hepatitis

C infected health care workers had transmitted infection to 15 patients. This, despite existing policy advice from the Advisory Group on Hepatitis

(AGH) on the subject.

The HSE also present the stark risks associated with percutaneous injury. Risk of infection estimated as high as 30% for Hepatitis B, 1-3% for

Hepatitis C and 0.3% for HIV.

Scalpel Blade Percutaneous Injuries

Of all operating room injuries, scalpel blades account for a lower percentage of injuries than needlestick, but can be seen as high risk due to their

percutaneous nature and further risk of longer-term mechanical injury.

Scalpels have the further potential to inflict deeper wounds than needlepoint injuries. The potential for mechanical injury also makes accidents

involving scalpels dangerous and disruptive with potentially more expensive compensation and rehabilitation costs.

The risks from scalpel blades represent a significant area of concern in healthcare and one that can benefit from improvement:

• A quarter of all percutaneous injuries are sustained in the operating theatre; scalpels are the second most frequent cause of injury, after

needles. (2)

• Massachusetts sharps injury surveillance system data, 2004 conducted by the Massachusetts Department of Public Health (MDPH) found that

scalpels accounted for 12% of injuries with Technicians suffering the most number of scalpel specific percutaneous injuries, followed by

Surgeons and Nurses.

• The same study highlighted up to 27% of sharps injuries in the OR occur in situations that have strong potential for primary prevention. These

injuries occur during handling or passing equipment, clean-up, and improper sharps disposal or procedure methods.

• Policies and procedures governing the use and disposal of scalpel blades are highly variable and are inconsistently followed. (3)

• The operating theatre is a unique environment in which many healthcare professionals work in close proximity, often over long periods, and

often under emergency conditions. (4)

Best Practices for Minimising Scalpel Percutaneous Injury in the Operating Room

But how do these injuries happen and how are they minimised? Injuries are essentially most likely in the following situations:

• During usage of the scalpel

• After use but before disposal

• Between procedural steps

• During disposal

• When activating safety-engineered devices

As the majority of scalpel injuries affect non-surgeons, it is important to consider the dangers posed by the passing and disposing of medical

sharps specifically.

In fact, numbers from the Massachusetts study alone suggest that almost 70% of scalpel injuries occur after use - identifying passing, assembly/

disassembly and disposal as key areas for focus.

In response to such dangers, medical facilities can develop a variety of safe practices to minimise their occurrence:

Neutral Zone / Hands-Free Passing

Make use of a ‘neutral zone.’ The neutral zone represents a reliable way to reduce scalpel injury in operating room environments using the Hands-

Free Passing Technique.

Fuentes et al found that approximately 50% of scalpel injuries were preventable using the HFPT. (5) This statistic is further emphasised by the fact

that the other 50% were non-preventable i.e. they occurred during usage.

A neutral zone such as a metal tray is an area chosen for the placement of sharps during surgery, lowering the amount of person-to-person passing

and is one of the most seamless and economical ways of implementing the hands-free passing technique (HFPT) in the operating theatre.

Use Blade Handling & Disposal Safety Devices

Risks to non-surgeons can also be reduced through the proper handling and disposal of sharps. Safety devices are proven to help reduce injury:

MDPH found that injuries during or after disposal most frequently involved scalpel blades (30%).

Fuentes et al recommended the use of a single-handed scalpel blade remover in combination with an HFPT / neutral zone as this can potentially

prevent 5 times as many injuries as a safety scalpel. (6)

Products widely available to support operating room staff include:

1. Single use blade removal devices.

2. Blade removal and disposal combination systems.

3. Sharps containers.

4. Magnetic drapes, metal trays and sharps recovery equipment.

5. PPE equipment including gloves and goggles.

6. Safety engineered scalpels.

Find out more 02921 680068 • e-mail Issue 371 August 2021 25

Effective Theatre Policy & Staff Training

Training, risk assessments and operating room policy can play a role in reducing sharps injury:

• Emphasising verbal communication can help physicians and nurse’s coordinate passes.

• Regular risk assessments can help flag potential hazards and plan effective responses to incidents, as well as help eliminate unnecessary risks


• Training on the safe attachment and removal of surgical blades can ensure best practices are adhered to at all times. Training on the use of

safety-engineered devices can help increase activation rates and reduce usability issues when in use.

• A well-defined and widely available sharps safety theatre policy will help identify and clarify risks and reinforce safety procedures and protocols.

Effective P.P.E

The use of personal protection equipment can clearly play a role in sharps injury reduction. Specifically Goggles and Gloves.

The most common area of injury is the hand according to the EPINet 2009 report - with 57% of injury superficial with little or no bleeding.

Health care workers’ eyes were identified by Jagger et al as being the most vulnerable location for serious blood exposures. (7)

How Can Safety-Engineered Devices Help Reduce Sharps Injuries?

Safety engineered devices are intended to reduce the risk of percutaneous injury during and after their use through the design of the product

itself. These devices are of two kinds: active and passive.

A 15-month, six-hospital study of OR exposures conducted jointly by the International Health Care Worker Safety Center and the Association of

periOperative Registered Nurses discovered that a high proportion of percutaneous injuries were potentially preventable if safer devices had been

used. (8)

An active safety device requires some action on behalf of the user to activate the safety feature; this could mean flipping a switch or clip, sliding

a sheath, or applying extra force via button press. A passive safety feature would be one that requires no action on behalf of the user; it could be

said to be ‘always on.’ Most scalpel engineered safety devices are classified as active.

Studies on Device Efficacy

Studies have shown conflicting conclusions on the efficacy of safety engineered devices in driving down sharps injuries. The below table summarises

the argument for and against such devices from various studies on the subject:


Reduced touchpoints; Safety engineered devices

provide a clear path to the reduction of sharps

injury given they are designed to reduce the

number of touchpoints associated with sharps

injury - specifically safe passing, removal and


Injury Reduction; Studies indicate that safetyengineered

devices can play a key role inside the

operating room.

Technology; Feedback from surgeons has

allowed the healthcare industry to improve the

design and usability of safety-engineered

products. Safety-engineered devices are now

available using standard surgical handles for

example to help promote an ergonomic feel.

Cost effectiveness; independent studies showing

the overall cost effectiveness of these devices in

preventing costly injuries.

Multi-use; procedures requiring multiple passing

between surgeon and nurse can be supported

more easily.


Patient safety; Surgeons feedback over concerns of

the devices usability during surgery with the

potential to obscure vision and reduce touch and feel.

Cost; Safety engineered devices are more expensive

than cheaper safety solutions such as HFPT / blade

removal systems.

Activation and Training; Research provides evidence

of sub-optimum activation rates as well as injury

during attempted activation. Use of safetyengineered

devices may require specialist staff

training which provide logistical issues for hospitals

and trusts.

Alternatives; Related safety products and procedures

such as HFPT provide comparably effective ways to

reduce sharps injury without needing to invest in

specific safety engineered devices.

Counterproductive; Safety engineered devices can be

argued as being potentially counterproductive in that

usage can increase hazards through misuse or from

poor training and/or limited usage experience.

Impact; Studies have shown that the impact from

safety-engineered devices can be short-lived with

injury rates returning to previous levels.


Swann-Morton Scalpel Safety Solutions

Swann-Morton supports the use of our surgical blades in theatre with a range of safety products designed to help reduce risk and injury amongst

healthcare professionals. Below is a short summary of the products we are able to provide.

Kleen Blade Management System

The Kleen Blade System is compatible with a wide variety of scalpel blades sizes. The system which incorporates a quality Swann-Morton surgical

blade is designed to operate with most No.3 and No.4 standard surgical handles already in circulation within the hospital system; thus minimising

disruption and cost during the conversion process.

Watch the Kleen Blade Management video here.

Blade Removal Devices

Single Use Blade Removers

Supplied sterile it allows the device to be included on the instrument tray within the OR and to be used at the site of the invasive procedure. 100%

accountability of the blades used during the surgical procedure, each one safely encapsulated within an individual remover which may then be

disposed of in an appropriate sharps bin or container.

Qlicksmart BladeFlask

This world-first single-handed scalpel blade remover helps prevent injuries commonly caused by removing blades with fingers, forceps or resheathing.

Installed with bracket, BladeFlask can be installed on walls, benches and trolleys inside the operating room. Simply insert the surgical

scalpel post-procedure for a seamless blade removal process.

Qlicksmart Blade Cassette

With the single-use BladeCASSETTE you can simply push and click to change and contain up to 3 blades during a procedure without risking the

other hand. Improves staff safety by ensuring the used scalpel blade is removed with a safe single-handed technique and then safely contained

until final disposal.

Qlicksmart BladeSingle

For a single blade use BladeSINGLE adopting a simple push and click action to change and contain blades.

You can learn more about these products by visiting our website:

• Learn more about our single use blade removers.

• Learn more about Qlicksmart safety solutions.

Can Swann-Morton Provide Further Safety Information?

Alongside our safety-engineered and sharps safety products, Swann-Morton offers a free training portal addressing the use of traditional and safety

scalpels, as well as all aspects of sharps injuries.

The training on offer is AFPP approved, and touches on all aspects of scalpel use and safety, from handling instruments, to risk factors and legal

frameworks. On the portal, you’ll find plenty of free information, as well as the opportunity to acquire training credits for your professional


Further information at:

When responding to articles please quote ‘OTJ’

References & Citations


Tavoschi L, Mason L, Petriti U, Bunge E, Veldhuijzen I, Duffell E. Hepatitis B and C among healthcare workers and patient groups at increased

risk of iatrogenic transmission in the European Union/European Economic Area. J Hosp Infect. 2019;102(4):359-368. doi:10.1016/j.jhin.2019.03.004


Watt AM, Patkin M, Sinnott MJ, Black RJ, Maddern GJ. Scalpel injuries in the operating theatre. BMJ. 2008;336(7652):1031. doi:10.1136/



Fuentes, Hector et al. ‘“Scalpel Safety”: Modeling the Effectiveness of Different Safety Devices’ Ability to Reduce Scalpel Blade Injuries’. 1 Jan.

2008 : 83 – 89.

(7, 8)

Jagger, J., Bentley, M., & Tereskerz, P. (1998). A study of patterns and prevention of blood exposures in OR personnel. AORN journal, 67(5),

2009 Exposure Prevention Information Network (EPINet) report -

NHS Hepatitis C Infected Health Care Workers guide -


Advisory Group On Hepatitis -

Risks to healthcare workers – Health & Safety Executive

Find out more 02921 680068 • e-mail Issue 371 August 2021 27

Canon Medical announces

strategic changes to

reinforce global HIT


ASGBI partners with Incision to promote

education and enhance surgical learning.

Canon Medical Systems Corporation has today

announced a major operational plan to strengthen

its healthcare information technology (HIT)


The HIT Division will broaden its capabilities and

leverage Canon Medical’s global infrastructure to

accelerate the delivery of a full range of Enterprise,

AI, and Collaborative imaging solutions. As part of

the development, Vital Images, Inc. will adopt the

Canon Medical brand to support a more unified

business approach.

The entire reform, which is expected to take time

to complete, will further solidify the company’s

goal of strengthening HIT as a key growth pillar

– enabling customers to access the full range of

solutions they can use to help improve patient

outcomes and decrease turnaround time in a

value-based healthcare system.

“This development represents a bold new future

for our company, our partners and our customers,”

says Toshio Takiguchi, CEO and President of Canon

Medical. “Enhancing our HIT solution and service

provision is the natural next step in a world that

demands accurate and immediate results across

the entire hospital enterprise.”

Jim Litterer, President and CEO of Vital Images,

Inc. says of the reform: “Canon Medical has a

well-established reputation for delivering leading

solutions that support the end-to-end needs of

the evolving healthcare systems. I am confident

that customers around the globe can look forward

to enhanced service delivery, uncompromised

quality, and an innovative approach to healthcare

– which is why I am excited to strengthen the HIT

Division under the entity name Canon Medical

Informatics, Inc., leveraging the global reach of

Canon Medical”.

The formal name change will be completed

effective Oct. 1, 2021.

Incision and The Association of Surgeons of Great Britain and Ireland (ASGBI) are excited

to announce a new collaboration to promote education and enhance surgical learning.

Members of the AGBI will get free access to selected courses within the Incision Academy

general surgery library. The Incision Academy contains over 500 high-quality video courses

on common surgical procedures.

Vice-President of the ASGBI, Ms Gill Tierney said, “The ASGBI is delighted to announce this

new educational collaboration with Incision. We know that one of the groups hardest hit

by the pandemic has been surgical trainees. There is a need for novel digital solutions to

enhance and complement training opportunities and we believe that the Incision Academy

provides just such a solution. We look forward to sharing this unique opportunity with

our members and, with their feedback, creating novel solutions to make things better for

trainees and ultimately patients.”

CEO of Incision, Mr Ritsaart van Montfrans said, “Incision is proud to be working together

with the ASGBI in an effort to support trainees across the UK. By making top quality

training materials, which have been accredited by the Royal College of Surgeons of England,

available digitally we hope to mitigate the impact of the pandemic on surgical training. Our

aim is to extend these capabilities to surgical units across the nation in order to ensure that

we get through the backlog as swiftly as possible.”

The 14 th Royal Marsden

Opioid, Cannabinoid &

Gabapentinoids Conference

What’s new in the science of opioids?

Wednesday 25 and Thursday 26 November 2021



ZEISS Introduces the Fully Integrated,

Data-Driven Medical Ecosystem

The ZEISS Medical Ecosystem enables multiple

layers of added value by connecting devices, data

and applications to optimize clinical management

of patients.

ZEISS recently announced its new ZEISS Medical

Ecosystem, a fully integrated environment where

a combination of devices, data management,

applications and services drive continuous improvement of patient

outcomes. This ecosystem distinctively combines unsurpassed ocular

expertise with leading-edge digital technology enabling evidence-based

ZEISS Introduces the Fully

decisions that assure more efficient delivery of the highest quality of

care in a single and secure platform.

Integrated, Data-Driven Medical


“At ZEISS, the core of our business strategy is shaping healthcare with

new technologies in order to advance medicine,” said Dr. Ludwin

The ZEISS Medical Ecosystem enables multiple layers of added value by

connecting Monz, President devices, data and and applications CEO of to optimize Carl Zeiss clinical Meditec management AG. of “With the ZEISS

patients. Medical Ecosystem, we are uniquely positioned to drive the digital

transformation of ophthalmology working with external partners,

including customers, healthcare providers and digital innovators.”

ZEISS recently announced its new ZEISS Medical Ecosystem, a fully integrated

environment where a combination of devices, data management, applications and services

drive “This continuous fully-connected improvement of patient platform outcomes. This will ecosystem continue distinctively to expand combines our integrated

unsurpassed ocular expertise with leading-edge digital technology enabling evidence-based

decisions workflow that assure solutions, more efficient adding delivery of value the highest for quality the of care customer in a single and and enabling new

secure ways platform. to maximize clinical efficiency and performance,” said Euan S.

Thomson, PhD, President of Ophthalmic Devices and Head of the Digital

"At ZEISS, the core of our business strategy is shaping healthcare with new technologies in

Business Unit for Carl Zeiss Meditec. “The power of digital technologies,

order to advance medicine," said Dr. Ludwin Monz, President and CEO of Carl Zeiss

Meditec data AG. management "With the ZEISS Medical and Ecosystem, a range we are of uniquely new positioned applications to drive the will create an

digital transformation of ophthalmology working with external partners, including customers,



providers and





automation, artificial intelligence, and

safe and efficient management of data, enabling improved results

"This for fully-connected patients. platform I truly will continue believe to expand that our the integrated digital workflow ecosystem solutions, will provide



value for the customer improve

and enabling new




to maximize clinical





delivery and

performance," said Euan S. Thomson, PhD, President of Ophthalmic Devices and Head of the

Digital ultimately, Business Unit quality for Carl Zeiss of life Meditec. for "The our power customers’ of digital technologies, patients.” data

management and a range of new applications will create an environment of connectivity,







and safe and efficient




of data,



easy, providing

improved results for patients. I truly believe that the digital ecosystem will provide

one ecosystem connecting devices, data and applications that enable

a streamlined workflow, clinical planning, education, and optimization

of clinical procedures. It opens possibilities for the creation of new

solutions, where data passes seamlessly from one ZEISS device to

another using artificial-intelligence-powered applications and software


“In our clinical environment, data management and efficient workflows

can be a challenge,” said Ranya Habash, MD, distinguished surgeon

and assistant professor of ophthalmology at the Bascom Palmer Eye

Institute, where she also serves as medical director of technology

innovation. “So combining new ZEISS technologies with our existing

equipment, even from other providers, allows for more accessible data

and helps me provide better care to my patients.”

With the ZEISS integrated portfolio of diagnostic and therapeutic

devices supported by a cloud-based digital platform, the ZEISS Medical

Ecosystem delivers value beyond the devices with a fully connected and

integrated approach that is unsurpassed in the medical industry.

For more information, visit

Enhanced Clinical Practitioner

Apprenticeship – Scoping survey

now open

To support the national uptake of the Enhanced Clinical Practitioner

(ECP) Apprenticeship, Health Education England (HEE) intends to

develop guidance and support material and also undertake a national

procurement to source both national and regional providers. To enable

this, HEE are asking employers to indicate their future workforce

demand alongside their views and suggestions for the use of the ECP


The survey is open until 31st August 2021 and you can respond here:

You can find out more about the ECP apprenticeship in the FAQs guide



JOBS IN New Zealand, Minimum 12

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Find out more 02921 680068 • e-mail Issue 371 August 2021 29

Fund surgery preparation for those stuck on the waiting list

or risk a grim outcome

With the waiting list figures being released today a group with partners including the Royal Colleges of Anaesthetists, Surgeons, Nurses, GPs,

Physicians, and many more is calling on the government to stop just throwing money into increasing capacity for operations and investing in private

healthcare service, which is only a quick fix and provide upfront funding for those stuck on the ever-increasing waiting lists to prepare for surgery.

Lawrence Mudford, a spokesperson for the Centre for Perioperative Care (A group which partners with six Royal Colleges and other health

organisations) and a cancer survivor said:

“A population who have been on waiting lists for protracted times will have deteriorated in their health. Patients will now be potentially at a lower

stare of preparedness both physically and mentally to undergo a procedure in hospital than before the pandemic.

“With waiting lists at over 5 million and around 400,000 people in England waiting over a year for their treatment. Focusing on getting the long

list of those waiting down rapidly, by throwing money at increasing capacity for operations and investing in private healthcare services to increase

the numbers of patients seen, is likely to provide the government with the best headlines. However not preparing patients for surgery could have

a large knock-on effect. Poorer outcomes of surgery. A new set of hospital patients who have a higher risk factor as they undergo surgery. More

chance of complications following surgery. A greater chance of readmission to hospital. More strain on Social Care following discharge. Patient

expectations not being met in their perceptions of the success of surgery. A potentially grim outcome to rapidly reducing the waiting lists.

“The government and healthcare leaders must realise that simply trying to do more surgery faster misses this opportunity to improve outcomes from

surgery – bringing positive financial benefits to the health service as well as benefitting patients. We must see upfront funding for prehabilitation,

in the form of preparation lists. that better supports preventive healthcare and prepares patients both physically and mentally for surgery. The

consequence of these changes will have a far-reaching impact on the government’s goal of a reduction of the backlog and benefit patients across

the country.”

Centre for Perioperative Care

CPOC is comprised of healthcare professional organisations committed to the promotion and development of perioperative care in the NHS.

Full list of CPOC partners: Royal College of Anaesthetists, Royal College of Surgeons of England, Royal College of Physicians, Royal College of

Nursing, Royal College of General Practitioners, Association of Anaesthetists, Royal College of Paediatrics and Child Health, Faculty of Public

Health and College of Operating Department Practitioners.


SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X



SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

The Operating SEPTEMBER 2020 ISSUE NO. Theatre 360 ISSN 0000-000X


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