The Operating Theatre Journal February 2022

THE THE
THE
SEPTEMBER FEBRUARY 2020 2020 2022 ISSUE ISSUE NO. NO. 360 NO. 360 377 ISSN ISSN ISSN 0000-000X
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SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X
The The Operating Theatre Theatre Journal
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THE THE
THE
SEPTEMBER FEBRUARY 2020 2020 2022 ISSUE ISSUE NO. NO. 360 NO. 360 377 ISSN ISSN ISSN 0000-000X
1747-728X
SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X
The The Operating Theatre Theatre Journal
Journal
OTJONLINE.COM £2.00
OTJONLINE.COM
£2.00
The The Leading Leading Independent Print Print & Digital & Digital Journal Journal For For ALL ALL Operating Theatre Theatre Staff
Staff
The Leading Independent Print & Digital Journal For ALL Operating Theatre Staff
QA4 MOBILE SURGERY SYSTEM FOR TRANSPORT,
TREATMENT AND RECOVERY
The benefits of a trolley that can be both patient
transport and operating table are now widely
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Manual handling – and all its inherent risk to patients
and practitioners – is massively reduced when a
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The practice also aids infection control, thanks to
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It can be used for a wide range of surgical specialisms
from ophthalmology and ENT to orthopaedics,
gynae, urology, vascular and general surgery. This
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The Build Options offered include alternatives
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These specialist Head Rests and Leg Sections, which
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All of the QA4’s features and benefits are detailed
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RUTHERFORD OFFERS NHS NOT-FOR-PROFIT CANCER SERVICES
Rutherford Health plc, a leading
independent provider of
advanced cancer care in the UK,
recently announced it has offered
its treatment and diagnostic
services to the National Health
Service on a not-for-profit basis
for the next three years.
The offer has been made to help
address delays being encountered
by cancer patients due to the
Covid-19 pandemic.
Rutherford
operates
cancer centres located in
Northumberland, Liverpool,
Thames Valley and South Wales
and its subsidiary Rutherford
Diagnostics operates a community
diagnostics hub in Taunton, in
partnership with Somerset NHS
Foundation Trust.
The offer of services includes MRI
and CT scans, ultrasound services,
chemotherapy, radiotherapy,
immunotherapy and proton beam
therapy. The ‘Cancer Recovery
Contract’ proposal would provide
thousands of treatment and
diagnostic sessions, creating
additional capacity for the NHS
to utilise as it deals with the
extensive backlog of cancer
patients.
Dr Mark Jackson, chairman of
Rutherford Health, said: “The
cancer backlog has been identified
by government and the healthcare
sector as a major challenge facing
the country. There is capacity
within the independent sector
and our offer to the NHS would be
viable due to economies of scale.
When responding to articles please quote ‘OTJ’
“The Prime Minister made clear
the scale of the challenge we
all face during his visit to our
diagnostic centre in Taunton last
week and the Secretary of State
for Health has stated that utilising
the independent sector can help.
For patients, the most important
thing is that they are cared for as
soon as possible.”
Sean Sullivan, chief executive
officer of Rutherford Health, said:
“We already work closely with
various NHS Trusts in providing
services and feedback we have
had from patients has been
tremendously positive. This offer
creates the opportunity to utilise
additional capacity which we
believe would be of benefit to
patients.”
Inside this issue
Mixed Reality and AI to aid
surgeons with keyhole heart
valve surgery
KidsOR- We did it!
Mobile Operating Theatre
hailed as ‘fantastic’
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 3
P4
P7
P7
Chief Sustainability Officer’s
Clinical Fellow Scheme
P7
Apprentice ODP’s at the
University Hospitals of Derby
and Burton; towards a future
workforce model
P8-9
Spare Parts, A Surprising History
of Transplants: In Conversation
with Paul Craddock
P10
New Operating Theatre
to open at Orpington
P12
Maxillofacial surgeon Jag
Dhanda secures £1m grant to
develop virtual and augmented
reality surgical training
P12
Physical activity protects
against type 2 diabetes
P17
New data on drug metabolism
and distribution in the eye
P21
OMFS Daniel Van Gijn
awarded Ellison-Cliffe
Travelling Fellowship
P22
Are you sure you are
allergic to penicillin?
P24-25
New Type of Medical
Helicopter Provides
Intensive Care in Transit
P25
New €10 million operating
theatres open in Bon Secours
Cork
P26
Where Are You Now?
P26
Karolinska University Hospital
First to Give Stem Cells
to Foetus
P28
Royal Oldham extension
takes a step closer to
improve patient care
P28
Europe’s oldest surviving
operating theatre
P29

Mixed Reality and AI to aid surgeons with keyhole heart valve surgery
Cardiac surgeons could in the future be
conducting procedures virtually before even
stepping into an operating theatre thanks
to researchers from the University of West
of England who are working with cardiac
surgeons from the University of Bristol on new
technology that will allow surgeons to better
predict risks and help prevent the conversion
of a keyhole heart valve operation to open
heart surgery.
The research team from UWE Bristol’s Big
Data lab and Faculty of Health and Applied
Sciences (HAS) is developing technology that
uses artificial intelligence (AI), augmented
reality (AR) and virtual reality (VR) to assist
cardiac surgeons in planning and preparing for
complex keyhole heart valve surgery.
The team is initially collaborating with the
Bristol Heart Institute (BHI), a Specialist
Research Institute at the University of Bristol,
whose surgeons will test the system when
preparing for minimally invasive cardiac valve
surgery (MICVS).
Compared to conventional open-heart surgery
involving cutting through the breastbone to
reach the heart, MICVS is less intrusive as the
heart is accessed through smaller incisions
using endoscopic instruments. And patient
recovery time is generally quicker after this
keyhole surgery.
However, MICVS is complex and requires hours
of pre-operative planning and preparation.
Dr Hunaid Vohra, Consultant Cardiac Surgeon
and Honorary Senior Lecturer and Researcher
at the BHI, who is collaborating with UWE
Bristol, said:
“In the operating room, despite pre-planning,
it is currently very common to find unexpected
challenges, as every patient’s height, weight
and heart-lung anatomy is different. And
patients’ frailty varies.
“Mixed Reality and AI will enhance our ability
to prevent the conversion of a keyhole heart
valve operation to an open heart surgery,
avoiding two sets of scars, and delay in
recovery.”
Surgeons will initially be able to use the
system’s AI to tap into the patient’s medical
data to predict the risks associated with the
procedure. The likelihood of adverse events is
then presented to the surgeon on a HoloLens
using AR.
Next, the surgeon will have access to AR
technology to show a patient a 3D version of
their heart and explain the procedure to them
via headsets.
Dr Muhammad Bilal, Associate Professor of Big
Data and Artificial Intelligence at UWE Bristol
and leading the research team, said: “Most
terms surgeons use to describe heart surgery
during consultation draw a blank from patients
and this system makes the explanation task
much clearer and easier.”
Incorporated in the system is also a preoperative
logistics element that optimises
operation planning. This will assist medical
teams in preparing the right instruments
and materials, and booking the appropriate
operating theatre and hospital beds, among
other tasks.
Crucially, the software’s virtual planning
feature will provide surgeons with access
to a complete digital version of the patient,
enabling them to perform the entire operation
beforehand on a replica of the patient’s
thoracic cavity. This will include ‘what-if’
scenarios to determine the most optimal and
personalised surgical strategies.
Finally, in collaboration with UWE Bristol’s
Centre for Print Research, surgeons performing
very complex cases will be allowed to order
a bespoke 3D printed model of the patient’s
thoracic cavity mimicking organs, veins, and
blood flow to simulate the procedure on a
synthetic body.
“This will enable us to practise before the
actual operation and minimise the potential
for things to go wrong on the day,” said Dr
Vohra. “Overall, we are excited to be involved
in this technology, which could spell the
future for highly successful minimally invasive
procedures of this type in adults and babies.”
Dr Bilal added: “Currently, the practice of
MICVS is limited to a small group of surgeons in
the world. This technology-enabled guidance
promises to increase the number of doctors
able to perform these operations, providing
wider access to the general population.
“There are significant engineering challenges
to be resolved before this technology can be
rolled out into the NHS but our collaboration
with the BHI provides a perfect testing
ground.”
When responding to articles please quote ‘OTJ’
The next issue copy deadline, Friday 25th February 2022
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4 THE OPERATING THEATRE JOURNAL www.otjonline.com

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The work we do would not be possible
without the support of many, but especially
of the medical professionals we work with. Dr
Amoah, a Senior Specialist Paediatric Surgeon
and the Head of the Paediatric Surgery Unit
at Komfo Anokye Teaching Hospital, joined in
congratulating us for achieving such a huge
milestone: “I pursued medicine out of passion
to help the sick to get appropriate medical
care, and I will now be able to do that to the
We
We
did
did
it!
it!
best of my ability thanks to KidsOR and the
If three years ago you asked the team of four
new Operating Rooms.”
If at three KidsOR years how ago many you asked Operating the team Rooms of four they at KidsOR how many Operating Rooms they
would have
have
installed
installed
by
by
the
the
end
end
of
of
2021,
2021,
the
the
answer would probably not have been the big
answer would probably not have been the
5 0. Today, we celebrate an incredible landmark as we officially open the 50th KidsOR
big 5 0. Today, we celebrate an incredible
Operating landmark Room, as we installed officially at the open Komfo the Anokye 50th Teaching Hospital, in Kumasi, Ghana. With
this KidsOR installation, Operating we are Room, creating installed capacity at for the more than 35,000 operations a year. That's
35,000 Komfo children Anokye Teaching every year Hospital, who now in can Kumasi, access the safe surgery they deserve.
Ghana. With this installation, we are creating
capacity for more than 35,000 operations a
year. That’s 35,000 children every year who
now can access the safe surgery they deserve.
Since the beginning, our vision has been simple: to create a world where every child has
access Since to safe the surgery by beginning, ensuring local surgical teams our have vision the necessary has tools to been care for
their nation’s children.
simple: to create a world where every child
has access to safe surgery by ensuring local
surgical teams have the necessary tools to
care for their nation’s children.
Staff at Komfo Anokye Teaching Hospital learning to use the new equipment
Staff at Komfo Anokye Teaching Hospital
“This learning is a remarkable to use achievement the new since equipment
our inception in 2018,
particularly as for nearly half of this time we have been living with a
global pandemic”
“This is a remarkable achievement since our
KidsOR
inception
Co-Founder,
in
Garreth
2018,
Wood
particularly as for nearly
half of this time we have been living with a
We believe in creating sustainable healthcare systems, which is why we don’t only install
and global equip Operating pandemic”
Rooms. As well as shipping all the necessary equipment for a paediatric
Operating Room from our Centre for Global Operations in Dundee, we also fund the training
of future paediatric surgeons through the provision of surgical scholarships.
KidsOR Co-Founder, Garreth Wood
The world over celebrates the incredible milestone #50KidsORs
We believe in creating sustainable healthcare
The work we do would not be possible without the support of many, but especially of the
medical
systems,
professionals
which
we work with.
is
Dr
why
Amoah, a
we
Senior Specialist
don’t
Paediatric
only
Surgeon
install
and
the Head of the Paediatric Surgery Unit at Komfo Anokye Teaching Hospital, joined in
congratulating and equip us for achieving Operating such a huge milestone: Rooms. “I pursued medicine As out well of passion as to
help the sick to get appropriate medical care, and I will now be able to do that to the best of
my shipping ability thanks to all KidsOR the and the new necessary Operating Rooms.” equipment for a
paediatric Operating Room from our Centre
for Global Operations in Dundee, we also fund
the training of future paediatric surgeons
through the provision of surgical scholarships.
The world over celebrates the incredible
milestone #50KidsORs
Since our inception in 2018, we have installed Operating Rooms across all over Africa and in
parts of Latin America. With the installation of these two Operating Rooms Ghana, we
Since our inception in 2018, we have installed
now have ORs in 20 countries.
Operating Rooms across all over Africa and in
Where it all started
parts of Latin America. With the installation
Dr
of
John
these
Sekabira was
two
one of
Operating
the very few paediatric
Rooms
surgeons working
in Ghana,
in Uganda. Based
we
in
the capital city of Kampala, he was trying to care for as many of the country’s 20 million
children now as have he possibly ORs could in – that's 20 about countries.
the population of New York.
Unfortunately, without a dedicated children’s Operating Room, the limited resources were
regularly Where allocated it to all adult started
surgeries. The solution seemed simple: create a dedicated
paedriatric operating theatre with its own admissions space.
Dr John Sekabira was one of the very few
paediatric surgeons working in Uganda. Based
in the capital city of Kampala, he was trying
to care for as many of the country’s 20 million
children as he possibly could – that’s about the
population of New York.
Unfortunately, without a dedicated children’s
Operating Room, the limited resources were
regularly allocated to adult surgeries. The
solution seemed simple: create a dedicated
paedriatric operating theatre with its own
admissions space.
Dr. John Sekabira in the first ever KidsOR installed Operating Room in Kampala, Uganda
Dr. John Sekabira in the first ever KidsOR
In high-income countries having a paediatric surgical wing is the norm; however, this isn’t
always installed the case low-and Operating middle-income countries.The Room KidsOR in team soon Kampala,
realised that
this simple approach was working and started planning to install as many children’s
Uganda
Operating Room as possible with the help of local surgical teams and health ministers.
Where In high-income next? countries having a paediatric
We surgical have huge plans wing and ambitions is the to bring norm; safe surgery however, to every child. By 2030, this we isn’t plan to
create 120 centres of excellence across East West Africa, each with world-class, stateof-the-art
always
operating
the
rooms,
case
pre -and post-operative
in low-and
care. We will
middle-income
also expand our work in
Latin
countries.The
America and other parts of
KidsOR
the world. We will
team
continue to
soon
advocate for
realised
children’s
surgery and the right for universal healthcare access.
that this simple approach was working and
started planning to install as many children’s
Andrew original article just for your reference and to see their layout:
https://www.kidsor.org/news/celebrating-the-installation-of-50-operating-rooms/
Operating Room as possible with the help of
local surgical teams and health ministers.
Where next?
We have huge plans and ambitions to bring
safe surgery to every child. By 2030, we plan
to create 120 centres of excellence across East
and West Africa, each with world-class, stateof-the-art
operating rooms, pre -and postoperative
care. We will also expand our work
in Latin America and other parts of the world.
We will continue to advocate for children’s
surgery and the right for universal healthcare
access.
Mobile Operating Theatre
hailed as ‘fantastic’
All photo: NHS Shetland
NHS Shetland chief executive Michael
Dickson has lavished praise on the mobile
operating theatre which opened its doors
in Lerwick earlier this month.
He said the set-up is “phenomenal” and
praised the care provided to patients locally
after their operations.
The Vanguard operating theatre will be in
place outside the Gilbert Bain Hospital for a
total of 12 weeks.
It was brought to Shetland to allow more
people to undergo operations amid a backlog
of cases caused by the Covid pandemic.
Services include cataract and ear, nose and
throat [ENT] surgery, while it also allows joint
replacement procedures such as knee and hip
operations to be carried out in Shetland for
the first time.
Speaking at an NHS Shetland board meeting
on Tuesday Dickson said the service has been
“truly outstanding”.
People have started having joint replacement
procedures this week, he added.
Dickson said it demonstrates what “makes
Shetland such a special place”.
NHS board chairman Gary Robinson said he
had been contacted by a couple of people
who had been unsure about having operations
in the “back of a lorry”.
But he said a video prepared by the health
board to advise people on what to expect put
them more at ease.
Up to 400 people are in line to undergo
procedures in the unit, which is funded by
the Scottish Government, over the coming
few months. Source: Shetland News Chris Cope
Chief Sustainability Officer’s
Clinical Fellow Scheme
The NHS Chief Sustainability Officer’s Clinical
Fellow Scheme offers clinicians with a passion
for sustainability a unique opportunity to help
build a greener NHS and improve health now
and for generations to come.
Successful candidates will step out of clinical
practice for 12 months to work with NHS
senior leaders and teams on key projects
that will accelerate progress towards a net
zero health service, while strengthening
their leadership and management skills.
The scheme welcomes applications from
allied health professionals, dentists, doctors
in training, healthcare scientists, nurses,
midwives, and pharmacists from across the
UK.
Learn more: https://bit.ly/34va0ft
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 7

Apprentice ODP’s at the University Hospitals of Derby and Burton; towards a future workforce model
Lead Author –
Mr Nigel D Roberts, MSc, BA(HONS), PGR student, ODP.
Lead Theatre Manager
Contributing Authors – Miss Jennifer Cuttell, ODP, Senior Clinical Educator theatres
- Miss Ellie Marks, RGN, Clinical Educator theatres
- Mrs Jennifer Flint, ODP, Clinical Educator theatres
- Mrs Grace Pearn, AHP Lead
- Professor Stephen Wordsworth, University of Derby
Keywords:
Apprentice, Operating Department Practitioners, Grow your own, Local, Educators, Covid-19, Health Care Assistants, Allied Health Professional
Abstract:
Objective: The University Hospitals of Derby and Burton in 2021, took the decision to recruit ninety apprentice Operating Department Practitioners
(ODPs) over a three-year period to help fill the gap of qualified registered theatre practitioners and to mitigate against the extraordinarily long
waiting lists that have resulted
THE
from Covid-19 pandemic
Methods: A project team was established solely for the recruitment of apprentice ODP’s. Internal and external recruitment via webinars, a
recruitment agency, UHDB screensavers, and NHS Jobs.
Findings: All apprentice ODP posts thus far have been recruited too. Applicants that were not successful, were offered Health Care Assistant (HCA)
include roles the UHDB operating merger, theatre, theatres to help over prepare 4 sites, them increased for the business future recruitment activity, safe events. staffing
for Conclusion: more theatre Growing sessions your own and staff the will new ensure operating that theatres students in planning. stay the organisation, as well as inspiring staff to apply, as the trust is a strong
and firm believer of ‘grow your own’.
There
Background:
are 223 NHS Trusts in England (Kingsfund, 2021) but only 157 have operating
theatres
In general,
(Supporting
the recruitment
Facilities
of ODPs
Data,
locally
2019/20).
is falling
There
mainly
are
due
seven
to the
NHS
course
regions
length
in
being
total,
extended (DipHE to BSc) and the tuition bursary being
abolished in September 2017. Other factors that may have an impact on recruitment to the profession could include UHDB merger, theatres over
with 4 sites, a total increased of 3,282 business operating activity, theatres. safe staffing The University for more theatre Hospitals sessions of Derby and and the new Burton operating theatres in planning.
(UHDB) There are are 223 located NHS Trusts in the in England Midlands (Kingsfund, region and 2021) is but one only of 25 157 NHS have Trusts operating within theatres (Supporting Facilities Data, 2019/20). There are seven
NHS regions in total, with a total of 3,282 operating theatres. The University Hospitals of Derby and Burton (UHDB) are located in the Midlands
wider Midlands region, with a total of 600 operating theatres.
region and is one of 25 NHS Trusts within the wider Midlands region, with a total of 600 operating theatres.
Table 1 details the number of trusts by region.
Table 1 details the number of trusts by region.
Table 1 – NHS England trusts by region.
London 23
Southwest 21
Southeast 22
Midlands 25
East 18
Northwest 26
Northeast & Yorkshire 22
THE
Total 157
UHDB are are one one of of only only five five Trusts Trusts Nationally Nationally with with more more than than fifty operating fifty operating theatres. theatres. There are two additional theatres opening in 2022, a Hybrid
theatre in April 2022 and a dedicated private patients theatre in the summer of 2022. This will mean that UHDB will have fifty-six operating
There theatres are and two over additional 600wte theatres staff. opening With in the 2022, number a Hybrid of patients theatre waiting in April for 2022 treatment and due to COVID-19, this was nationally estimated to be
a 4.7million currently
dedicated
(2021), in private April this 2021. patients
is That just under
theatre is half highest in the
of the number summer
registered since of 2022.
workforce, records This began will
and
mean in 45 2007. could
that Of UHDB those 4.7million patients, 387, 885 are waiting more than 52
weeks
retire within
for routine
the next
operations
5 years
and
(Aged
procedures.
51 – 65)
(BMJ, 2021). UHDB carry out more than 300 elective procedures each working day.
will have fifty-six operating theatres and over 600wte theatre staff. With the number of
Table two shows that half of the current Operating Department Practitioners (ODP) workforce could retire in the next 3-5 years at UHDB. UHDB
patients have 138 waiting ODPs currently for treatment (2021), due this is to just COVID-19, under half this of the was registered nationally workforce, estimated and to 45 be could retire within the next 5 years (Aged 51 – 65)
4.7million Current workforce in April 2021. age profile That is across the highest UHDB theatres number (ODP) since records began in 2007. Of
Current workforce age profile across UHDB theatres (ODP)
those 4.7million patients, 387, 885 are waiting more than 52 weeks for routine
operations and procedures. (BMJ, 2021). UHDB carry out more than 300 elective
procedures each working day.
Table two shows that half of the current Operating Department Practitioners (ODP)
workforce could retire in the next 3-5 years at UHDB. UHDB have 138 ODPs
Discussion:
2
The University hospitals of Derby and Burton (UHDB) are moving to a 50/50 nurse/ODP split to keep up with retirements, maintain the current
workforce Discussion: and develop expanded service activity, as well as retain job satisfaction for nurses and ODPs, develop the current workforce, offer a
recruitment incentive as the Trust invests in the workforce and a career pathway from Apprentice HCA to Qualified ODP.
The University hospitals of Derby and Burton (UHDB) are moving to a 50/50
nurse/ODP 8 split to keep up with retirements, THE maintain OPERATING the current THEATRE workforce JOURNAL and
www.otjonline.com
develop expanded service activity, as well as retain job satisfaction for nurses and

Why Chose the Apprentice ODP route?
The BSC (Hons) ODP course will be delivered over three years, during which Apprentice learners will be supported to develop new skills and
knowledge that will allow them to work in today’s dynamic, complex and changing healthcare environment. Whilst the apprentice ODPs are
allocated to theatres, they will experience working across clinical placements areas, in varied settings, to enable the apprentice to gain essential
experience and achieve the learning outcomes of the curriculum.
The apprenticeship combines clinical practice-based learning with level six academic modules.
Why having Apprentice ODP’s is positive development for both the learner and
organisation? Why having Apprentice ODP’s is positive development for both the learner and organisation?
Apprentice HCA
Qualified HCA - NVQ Level 2
THE
Assistant Theatre Practitioner (ATP)
Qualified HCA - NVQ Level 3
Apprentice ODP - Internal or external candidate
Band 5 Theatre Practitioner
Surgical First Assistant (Part 1)
Surgical First Assistant (Part 1)
Band 6 - Senior Theatre Practitioner
Clinical Educators
Surgical First Assistant (Part 2)
Band 7 - Lead Practitioner
Senior Clinical Educator
Band 8A Theatre Manager , Band 8 B - Theatre Lead
What to expect as an Apprentice ODP?
What to expect as an Apprentice ODP?
As an apprentice ODP, and if you’ve never worked in a healthcare setting, in the first six months, you will undertake the care certificate whilst
As working an apprentice as a ODP, Health and Care if you’ve Assistant. never worked Once in a you healthcare have passed setting, in this the first you will be able to join the University and access the ODP, BSc (Hons) course. As an
six apprentice months, you ODP will undertake you will the work care and certificate achieve whilst competencies working as a Health in supporting Care the patient through the entire pathway from arrival in the theatre suite,
during their operation and supporting them onto their recovery pathway. Day case, emergency, and trauma care, managing the preparation of
the operating theatres and care of patients undergoing their operation and finally recovery of the patient once their surgery has been completed.
The relationship between UHDB and the University of Derby (UoD)?
THE
UHDB, in partnership with the University of Derby, is offering an opportunity to undertake an Allied Health Professional training as an Operating
Department Practitioner and be paid whilst learning.
Bibliography:
BMJ 2021
KINGSFUND.ORG.UK
NHS Waiting list hits 14-year record high of 4.7million people
https://www.bmj.com/content/373/bmj.n995
[Accessed 20th January 2022]
Key facts and figures about the NHS
https://www.kingsfund.org.uk/audio-video/key-facts-figures-nhs
[Accessed 20th January 2022]
NHS ENGLAND, 2019-20
THE
THE
THE
Supporting facilities data, operating theatres in NHS organisations in England, quarter 3 2019-20
4
https://www.england.nhs.uk/statistics/statistical-work%20areas/cancelled-elective-operations/supporting-facilities-data/
[Accessed 20th January 2022] SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X
OTJONLINE.COM
SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X
The Operating SEPTEMBER 2020 ISSUE NO. Theatre 360 ISSN 0000-000X
Journal
The TheOperating OperatingTheatre WWW.OTJONLINE.COM
TheatreJournal
Get Your Personal copy from
The Leading Independent Print & Digital Journal For ALL Operating Theatre Staff
ODPs, Find Theatre, out more 02921 Anaesthetic 680068 • e-mail & Recovery admin@lawrand.com Nurses Issue 377 February 2022 9
OTJONLINE.COM
£2.00
£2.00
Jobs, News, Study Days, Books,
Clinical Articles

DECON UK 2022 6th April 2022,
Molineux Stadium, Wolverhampton
Event website: https://fitwise.eventsair.com/deconuk2022/
This event is free to healthcare professionals and only £55 for
industry attendees.
The Royal Wolverhampton NHS Trust and University Hospitals
Birmingham NHS Foundation Trust jointly brings you DECON UK 2022.
This one day conference is taking place at Molineux Stadium in
Wolverhampton on 6 April 2022 and promises to offer delegates the
latest in decontamination education and expertise, with informative
sessions and a range of exhibiting companies.
Who should attend?
DECON UK 2022 will be of particular interest to sterile services
managers, decontamination leads, GP’s, theatre nurses, infection
control and endoscopy staff.
Programme Highlights
We aim to provide a high quality of educational content to our
delegates, this will cover:
• Protein residue removal from surgical instruments and endoscopes
• What can go wrong in decontamination services
• What happens when a healthcare trust fails to deliver safe water
• Endoscopy waters and reprocessing
• Decontamination – the chemistries
• Role of the authorising engineer
• Biofilms and how to remove them
In addition to the educational component of the day, this event will
also highlight the products and services of commercial companies
within this sector and how they can aid in the everyday, working
lives of our delegates.
Register now at https://fitwise.eventsair.com/deconuk2022/
The Old Operating Theatre
Museum & Herb Garret
Spare Parts, A Surprising History of Transplants:
In Conversation with Paul Craddock
7th April 2022 18:00-19:00 £5
Join us on Thursday, 7 April 2022, from 6 to 7
pm for an incredible virtual in conversation event
with Dr. Paul Craddock, author of “Spare Parts:
A Surprising History of Transplants.” So how did
an architect help pioneer blood transfusion in
the 1660s? Why did eighteenth-century dentists
buy the live teeth of poor children? And what role
did a sausage skin and an enamel bath play in
making kidney transplants a reality? We think of
transplant surgery as one of the medical wonders
of the modern world. But transplant surgery is
as ancient as the pyramids, with a history more
surprising than we might expect.
Paul Craddock’s book takes us on a journey – from sixteenth-century
skin grafting to contemporary stem cell transplants – uncovering stories
of operations performed by unexpected people in unexpected places.
Bringing together philosophy, science and cultural history, Spare Parts
explores how transplant surgery constantly tested the boundaries
between human, animal and machine, and continues to do so today.
About the author:Paul Craddock is Honorary Senior Research
Associate in the Division of Surgery and Interventional Sciences at UCL
Medical School in London. His PhD explored how transplants have for
centuries invited reflection on human identity, a subject on which he
has also lectured internationally. Spare Parts, which won a Special
Commendation from the Royal Society of Literature, is his first book.
You will have the opportunity to ask questions via the ‘chat’ function at
the end of the conversation.
Ticketholders will receive a link to join the talk 15 minutes before the
start of the event. If for whatever reason ticketholders can’t make the
live event, they will have access to the recording of the event for three
days after they receive the link.
*All income from ticket sales go to support the upkeep of the museum
and the collection.
Book here: https://bit.ly/35KwKJd
When responding please quote ‘OTJ’
The Second Annual
Operating Theatres Show
THE KIA OVAL, LONDON
11TH OCTOBER 2022
Save 20% with code OTJ20
www.igpp.org.uk/otj
View the agenda today
10 THE OPERATING THEATRE JOURNAL www.otjonline.com

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New Operating
Theatre to open at
Orpington Hospital
Hundreds more operations will
be carried out each year
Maxillofacial surgeon Jag Dhanda secures £1m grant to
develop virtual and augmented reality surgical training
Professor Jag Dhanda, a Consultant Maxillofacial/Head and Neck Surgeon (OMFS) at the Queen Victoria
Hospital, East Grinstead and Honorary Professor of Surgery at the
Brighton and Sussex Medical School, has won a £1m grant from Health Education England (HEE) to develop
virtual reality (VR) and augmented reality (AR) surgical training resources.
“I hope I can demonstrate how this exciting new immersive technology can overcome the dramatic impact
that COVID has had on medical and surgical education. I want to prove that
A new state-of-the-art operating
theatre is being installed at
Orpington Hospital to enable
hundreds of additional operations
to take place each year.
The operating theatre and
recovery suite, which is due to
open in early 2022, is earmarked
primarily for orthopaedic
procedures. The new facility will
help reduce waiting times for
people who require knee and hip
replacement surgery, and other
procedures.
The new one-storey operating
theatre will also contain three
patient recovery bays, as well
as staff changing facilities. The
floorplan is specifically designed
to keep noise transfer from
corridors and other rooms to a
minimum, reducing disturbance
during patient recovery. Over the
next few weeks, the operating
theatre will be fitted out with the
latest equipment.
The building is a modular
construction, which is more
sustainable and is better for the
environment. The steel used has
at least 25 per cent recycled
content and as the parts were
built in an off-site factory –
before being delivered and fitted
together at the hospital – 90 per
cent of the waste produced was
also able to be recycled.
VR and AR can deliver lasting improvements to surgical training across wide range of skills, and validate their
use as medical education resources,” Professor Dhanda explained.
He said that General Medical Council (GMC) had found that the COVID pandemic had had a significant impact
on surgical training: “Trainees say they haven’t been able to compensate
for the lost training opportunities, and fear they have not progressed curriculum competencies. So, I believe
this emerging technology is an addition to conventional face-to-face training – and has the potential to
replace it!”
Professor Dhanda is the founder and clinical lead of Virtual Reality in Medicine and Surgery (VriMS), a freefor-trainee
platform that live streams surgical training videos in virtual reality.
VriMS now has over 400 videos filmed in virtual reality from 10 surgical specialties, and has just added
another 100 videos.
“A course has just finished where new content was live streamed and previous content restreamed. And,
there will be an additional hands-on course for OMFS surgeons (CRANIOMAX),
ENT and neurosurgeons that will also feature augmented reality applications for endonasal skull base access
and procedures.”
With the help of Professor Claire Smith, Head of Anatomy at Brighton and Sussex Medical School, cadaver
demonstrations of surgical techniques using virtual reality have been live streamed over five one-week
courses since the start of the pandemic.
Professor Dhanda said he also wanted VriMS to use eye tracking and physiological sensors with haptics to
show adaptions to training and trainee responses to VR/AR technology.
“I plan to use the grant to develop a true VR basic life support app for health care professionals and teachers,
and augmented reality apps for mandatory training with manual handling. Also, true VR apps for basic
surgical skills such as suturing and local skin flaps,” he added.
Professor Dhanda now plans a major project grant application to Innovate UK.
When responding to articles please quote ‘OTJ’
Jonathan Lofthouse, Site Chief
Executive, said, “The additional
operating theatre is a fantastic
addition to our services at
Orpington Hospital. It will help
us tackle waiting lists that have
grown during the COVID-19
pandemic so that patients receive
the timely care they deserve.
“The additional theatre capacity
will benefit people living locally,
as well as those living across
South East London, who may be
referred to Orpington Hospital for
treatment.”
Orpington Hospital, which was
rated Good during its last CQC
inspection, is part of King’s
College Hospital NHS Foundation
Trust.
Source: Mirage
12 THE OPERATING THEATRE JOURNAL www.otjonline.com

THE
SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X
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THE
SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X
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Journal
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The Leading Independent Print & Digital Journal For ALL Operating Theatre Staff
Jobs, News, Study Days, Books,
Clinical Articles £2.00
Register Today at:
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Jobsite:
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Registration is Free !
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The Mistral-Air® Forced Air Warming unit is now available with a new
Mistral-Air® Quick Connector. The Surgical Company, which manufacturers
the unit, developed the new connector after consulting with healthcare
providers. The Mistral-Air® Forced Air Warming system is available from
Central Medical Supplies (CMS), along with a wide range of warming
blankets and suits. CMS has extensive knowledge and expertise in providing
hospital trusts with patient warming products.
The new Mistral-Air® Quick Connector makes it easier to connect and
release the hose to the unit, along with being simpler to clean. The new
connector also reduces the chance of damaging the blower and the hose.
Mistral-Air® is a Forced Air Warming device that enables the safe,
comfortable and smart management of patient temperature, to achieve
normothermia. The Mistral-Air® Forced Air Warming unit helps prevent
inadvertent perioperative hypothermia, to reduce surgical site infections,
the length of hospital stay and the cost per patient.
The Mistral-Air® Forced Air Warming unit optimises heat transfer, due
to its multi sensor technology. The unit’s powerful fan eliminates air
contaminants via the HEPA filter. The filter can operate for 2,000 hours
before needing to be changed, as opposed to between 500 and 1,000 hours
for other systems. The benefits of a longer run time include a decrease in
downtime and reduced filter costs. The Mistral-Air® unit is flexible to use,
due to its slim and lightweight design.
Mistral-Air® Now Available With
Quick Connector
For more information on Mistral-Air®, contact Tracey Pavier-Grant, Medical
Sales Director at Central Medical Supplies, on 01538 392 596 or email
tracey@centralmedical.co.uk.
More information is also available by visiting www.centralmedical.co.uk
The Mistral-Air MA 1200.
When responding to articles please quote ‘OTJ’
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 13

INTS2022
BERLIN
GERMANY
© Marco2811 - Fotolia.com
15 th International
Neurotrauma Symposium
Improving lives after neurotrauma through research
17–20 July 2022
Pre-symposium-courses scheduled for 17 July
www.neurotrauma2022.com
SHARE Conference 2022
Learn more: https://bit.ly/3IYy9KE
The Sustainable Healthcare,
Academic Research and
Enterprise (SHARE) conference
The will Sustainable take place online, Healthcare, Academic Re
Enterprise May 6th 2022. (SHARE) conference will take p
6th Co-hosted 2022. by Brighton and
Sussex Medical School, the
University of Brighton School
Co-hosted of Sport and by Health Brighton Sciences and Sussex Medica
University and the Centre of Brighton for Sustainable School of Sport and
and
Healthcare,
the Centre
the
for
conference
Sustainable Healthcare
will feature keynote talks,
will presentations feature keynote and posters talks, presentations an
research about research and practice and practice for sustainable heal
is for now sustainable open, and healthcare. you may submit an abstr
Registration is now open, and
oral you presentation may submit an by abstract completing for the online
a poster or oral presentation by
Learn completing more: the https://bit.ly/3IYy9KE
online form.
Further information - https://bit.ly/OTJSC2022
The NHS Surgery Conference 2022:
Innovating through backlogs
The NHS Surgery Conference 2022:
14 THE OPERATING
10:50
THEATRE
am
JOURNAL www.otjonline.com
The NHS March Surgery 1, 2022 Conference 2022:

The Association for Perioperative Practice (AfPP)
Thanks to AfPP I have a greater understanding of the
perioperative environment and what I can do to make myself
a better practitioner. Every practitioner should be a member.
Selina, AfPP Member and Clinic Nurse
Join
today from
£5
*
*
AfPP is the UK’s leading membership organisation dedicated to all theatre practitioners. We’re
committed to improving patient care and safety through developing, providing and promoting leading
standards in perioperative practice. Our aim is to help you become the best practitioner you can be.
Take a look at what membership of AfPP gives you:
Professional Development
Online Education: Webinars and online resources to help you
become a better practitioner and gain CPD hours.
Networking: Online member discussion forums and regional
teams to share information and best practice.
The Journal of Perioperative Practice: Our highly respected
peer reviewed Journal, delivered FREE 10 times a year.
EBSCO Health: FREE access to the leading provider of evidence
based clinical decision support solutions, healthcare business
intelligence, and peer-reviewed medical research information.
Annual Conference: Guaranteed to educate, challenge
and inspire you. Reduced delegate rates for members.
Support & Advice
Professional Advice Service: Specialist clinical support
and advice from experienced healthcare professionals
available FREE.
Wellbeing and Mental Health Support: FREE membership
to Togetherall, a 24/7 online service, providing a supportive
community, information and self-help resources.
Medical Professional Liability Insurance: Created for
practitioners working in and around operating theatres.
Premium is in addition to AfPP membership fee.
*£5 per month refers to Student Membership. £8.75pm Registered, £7.25 pm Non-registered.
Join today www.afpp.org.uk or call 01423 881 300
@SaferSurgeryUK
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: afpp.org.uk

Medtronic announces first procedure in Europe with Hugo
robotic-assisted surgery system
Robotic prostatectomy performed by Doctor Alexandre Mottrie at Onze-Lieve-Vrouw Ziekenhuis (OLV) in Aalst, Belgium
The Hugo system is a modular, multi-quadrant platform for softtissue
robotic-assisted surgery.
Medtronic plc (NYSE:MDT), a global leader in healthcare technology,
and OLV Hospital Aalst today announced that the first clinical procedure
in Europe was performed with the Hugo robotic-assisted surgery (RAS)
system. The robotic prostatectomy was performed by Prof. Alexandre
Mottrie, M.D., head of urology at OLV Hospital in Aalst, Belgium, and
chief executive officer and founder of the Belgium-based ORSI Academy,
a multidisciplinary center for training, research and development, and
data analysis to improve minimally invasive surgery best practices.
“Performing Europe’s very first procedure with the Hugo RAS system
is a career highlight for me,” said Dr. Mottrie. “With more than two
decades and 4,000 robotic-assisted surgery procedures under my belt,
I am intimately aware of the barriers that have kept the benefits of
surgical robotics from physicians, hospitals, and patients. Now, I believe
we are entering a new era filled with greater access and flexibility.”
A form of minimally invasive surgery, robotic-assisted surgery offers
fewer complications, shorter hospital stays, faster return to normal
activities, and smaller scars than open surgery.1–3,†
“This is an exciting and important moment for healthcare in Europe
and we’re proud to share it with Dr. Mottrie and the team at OLV,”
said Megan Rosengarten, president of the Surgical Robotics business,
which is part of the Medical Surgical Portfolio at Medtronic. “Dr.
Mottrie has left a meaningful mark on our program over the many years
we’ve worked together, and now, through our partnership with OLV,
Medtronic’s journey to bring the benefits of robotic-assisted surgery to
more patients in Europe is well underway.”
The Hugo RAS system — Medtronic’s solution to historic cost and
utilization barriers that have kept surgical robotics out of reach for
many hospitals — is a modular, multi-quadrant platform designed for a
broad range of soft-tissue procedures. It combines wristed instruments,
3D visualization, and Touch Surgery Enterprise, a cloud-based surgical
video capture and management solution, with dedicated support teams
specializing in robotics program optimization, service, and training.
In 2021, Medtronic announced the first urologic and gynecologic
procedures with the Hugo system in Latin America and Asia-Pacific.
Those procedures and cases in Europe will become part of the Hugo
RAS system patient registry, which is collecting clinical data to support
regulatory submissions around the world.
“The Hugo RAS system introduces the long-awaited power of choice
in the category and will redefine all that robotic-assisted surgery can
make possible,” said Henk Westendorp, senior country director Benelux
at Medtronic. “Medtronic thoughtfully designed the Hugo RAS system
with surgeons in mind and patients at heart to tackle today’s barriers
to adoption in a future-proofed way. We know that by innovating real
solutions for the way surgeons want to work — alongside partners like
OLV Hospital Aalst who share our passion for advancing patient care —
we can make a substantial impact.”
“We’re incredibly proud to have left our stamp on medical history
as the very first center in the region to embrace surgical robotics in
1999,” said Peter Verhulst, chief executive officer, OLV Hospital Aalst.
“Decades later, we are delighted to be recognized as a robotic surgery
center of excellence, leaving another indelible mark as the first hospital
in all of Europe to offer the Hugo RAS system and the first in the world
to have Medtronic’s two RAS platforms — the Hugo system for soft tissue
and the Mazor system for spinal surgery. The OLV Hospital closely
monitors innovation in the medical world and often plays a pioneering
role in the introduction of new minimally invasive techniques. The
worldwide reputation of our OLV doctors in the field of robotic surgery
and other minimally invasive procedures is a result of this. With the
Hugo RAS system, we are again at the forefront, with the latest medical
innovation that is designed with the patient at heart.”
The Hugo RAS system is commercially available in certain geographies.
Regulatory requirements of individual countries and regions will
determine approval, clearance, or market availability. In the EU, the
Hugo RAS system is CE marked. In Canada, the Hugo RAS system has a
medical device licence. The Hugo RAS system is approved in Australia.
In the U.S., the Hugo RAS system is an investigational device not for
sale. Touch Surgery Enterprise is not intended to direct surgery, or aid
in diagnosis or treatment of a disease or condition.
For more information, visit medtronic.com/hugo.
Any forward-looking statements are subject to risks and uncertainties
such as those described in Medtronic’s periodic reports on file with
the Securities and Exchange Commission. Actual results may differ
materially from anticipated results.
† Compared to open surgery.
1. Fitch K, Engel T, Bochner A. Cost differences between open and minimally
invasive surgery. Managed Care. 2015;24(9):40–48.
2. Tiwari MM, Reynoso JF, High R, Tsang AW, Oleynikov D. Safety, efficacy, and
cost effectiveness of common laparoscopic procedures.
Surg Endosc. 2011;25(4):1127-1135.
3. Roumm AR, Pizzi L, Goldfarb NI, Cohn H. Minimally invasive: minimally
reimbursed? An examination of six laparoscopic surgical procedures.
Surg Innov. 2005;12(3):261–287.
When responding to articles please quote ‘OTJ’
16 THE OPERATING THEATRE JOURNAL www.otjonline.com

Congratulations, you are now reading, the extended OTJ
The Operating Theatre Journal
Discovering the many more pages available online @ www.otjonline.com
Physical activity protects against type 2
diabetes by modifying metabolism
Regular physical activity significantly changes the body’s metabolite profile, and many of these changes are associated with a lower risk of type
2 diabetes, a new study from the University of Eastern Finland shows. The study population included more than 7,000 men who were followed
up for eight years. Men in the highest physical activity category had a 39% lower risk of type 2 diabetes than men who were physically inactive.
Physical activity was associated with the levels of a total of 198 metabolites, i.e., compounds formed as a result of the body’s metabolism, and
increased physical activity had an impact on some of the same metabolites that have previously been associated with a health-promoting diet.
In addition, the study showed that increased physical activity improves insulin secretion.
A total of 1,260 metabolites were analysed from the study participants’ fasting glucose samples. The association of physical activity with the
metabolite profile hasn’t been studied this comprehensively nor in such an extensive cohort before. Indeed, published in Metabolites, this study
is the first to establish an association between many metabolites and physical activity.
The researchers investigated the association of physical activity with metabolite profile, insulin sensitivity, insulin secretion and risk of type
2 diabetes in men participating in the METabolic Syndrome In Men (METSIM) study. None of the participants had diabetes at the onset of the
study. A physical activity questionnaire was conducted among the participants at the onset of the study and again eight years later, and they
also underwent an oral glucose tolerance test and had their metabolites analysed from a fasting glucose sample.
Men were classified into four categories based on their physical activity: those who were physically inactive, those who were physically active
only occasionally, those who were physically active regularly but no more than twice a week, and those who were physically active regularly at
least three times a week. The duration of a single session of physical activity was defined as at least 30 minutes.
Physical activity was associated with the levels of a total of 198 metabolites. Among other things, physical activity changed the levels of several
lipids in a manner that in previous studies has been associated with a lower risk of type 2 diabetes. In previous studies, a health-promoting
diet has also been observed to have some similar associations with unsaturated fatty acid levels, for example. As completely new metabolic
biomarkers associated with physical activity, the researchers identified in particular steroids, amino acids, imidazoles, carboxylic acids, and
hydroxy acids.
During the follow-up, the risk of developing type 2 diabetes was 39% lower for men who were physically the most active, and 30% lower even for
men who were physically active no more than twice a week, when compared to men who were physically inactive. Lower fasting glucose and
insulin levels, and better insulin sensitivity and insulin secretion, were observed in men who increased their physical activity during the followup.
The association of physical activity with insulin secretion has remained unclear, despite several studies on the matter. The study published now
confirms that increased physical activity improves insulin secretion.
For further information, please contact:
Susanna Kemppainen, MSc (Health Sciences), Early Stage Researcher, University of Eastern Finland, Institute of Public Health and Clinical
Nutrition, susanna.m.kemppainen@uef.fi
Research article:
Susanna M. Kemppainen, Lilian Fernandes Silva, Maria A. Lankinen, Ursula Schwab, and Markku Laakso. 2022. Metabolite Signature of Physical
Activity and the Risk of Type 2 Diabetes in 7271 Men. Metabolites 12, no. 1: 69. https://doi.org/10.3390/metabo12010069
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 17

Demand for modern methods of construction (MMC) during Covid
David Hartley, managing director at MTX, shares his view on the many reasons why the demand for modern methods of
construction has increased in the last two years
In what has been an unprecedented time for all, the healthcare sector has been the most dramatically affected by the COVID-19 pandemic.
With increased patient demand came extended waiting lists and resource shortages, which meant existing infrastructure simply couldn’t cover
the surge. This saw the introduction of measures such as the regional Nightingale Hospitals – quick and large-scale, but often only temporary
structures.
Despite having been an already fairly popular choice for healthcare construction, twinned with the Government’s drive to build back better,
greener, faster, the COVID-19 pandemic has accelerated demand for Modern Methods of Construction (MMC) and shone further light around the
benefits of modular when compared to more traditional alternatives.
The availability of high-quality modular buildings has provided an effective solution for a healthcare sector faced with increased pressure on
funding whilst urgently needing for additional facilities.
Since the creation of the NHS SBS Framework in 2017 – a recommended supplier list for the public sector – more than £341m of work has passed
through the framework. Over £307m of that was accounted for in the last three years, inclusive of 2021. Although this is not strictly related to
healthcare, the majority of it certainly is, and this shows the sheer scale of the rise in demand for modular construction.
“MMC can cut build times by 50%”
During a period in which demand was driven by speed and cost efficiency, modular solutions offered NHS Trusts exactly that. When compared
with traditional construction methods, MMC can cut build times by as much as 50%, dependent on the various factors at play. Even in the midst
of a global pandemic, a recent project we completed at Norfolk and Norwich University Hospital cut what would have typically been a three-year
project into just one, despite the difficulties and disruptions being at an all-time high.
Modular also provides a greater amount of flexibility. With the majority of works able to take place offsite, the pre-manufactured value of
the project means that there is much less disruption for the healthcare provider – we require less time onsite, less space, and less logistical
interference from the likes of delivery of materials.
This was of course of particular importance of late, as it meant that NHS Trusts can continue to serve their patients and provide them with the
care that they need, without the noise of the works for example. Sites that are based in the heart of the city centre could benefit most from this,
or for those builds that are connecting to existing infrastructure.
As a business, we’ve been fortunate enough to secure 15 new projects during the pandemic – these have been for a variety of different
requirements, from stand-alone buildings to extensions in which to house additional patients or operating theatres. With latest figures from the
NHS claiming a backlog of around 100,000 procedures each month alone, and 5.7 million people on the waiting list*, the demand for MMC shows
no signs of abating.
FLEX
To further support the NHS, we’ve also recently launched a new product – FLEX – a completely new service offering for the industry and the first
of its kind. FLEX acts as a rapid solution to increase clinical capacity which is flexible, accessible and improves running efficiencies. Delivering
fast, full-service hire extensions, via a simple pay-as-you-grow, fixed-term monthly fee the new product offering supports the Government’s drive
to build back better.
Utilising standardised operating theatre suite and ward designs, developed in collaboration with leading consultants and clinicians means FLEX can
be deployed at pace, whilst allowing Trusts to better utilise staff by extending existing recoveries and dovetailing into existing resource.
With such high pressure on the NHS following the strain of the Coronavirus pandemic, we need to be thinking differently about how we meet
patient demand. Seeking capital funding for expansions can be a timely process, but single-source funding provides another way, allowing the
costs to sit off balance sheet, while at the same time enhancing a Trust’s ability to serve patients, stakeholders and the general community.
Although modular solutions have always been a great option for NHS Trusts and private healthcare providers, the Covid pandemic has shone a light
on the key benefits they offer. With such pressures on the NHS, speed and minimal disruption have been exceptionally important, and the figures
speak for themselves when it comes to the increase in MMC demand.
Source: pbctoday
18 THE OPERATING THEATRE JOURNAL www.otjonline.com

general surgery planned to be introduced in 2022. We have an exciting opportunity for
experienced theatre staff to join our expanding team. We have opportunities for:
Vacancy
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Theatre staff vacancies, Barlborough
Scrub practitioners Surgical first assistants Anaesthetic practitioners
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Salaries from
staff
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to our NHS and private
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come The If you benefits are here a part by of choice one working sonia.sanghvi@practiceplusgroup.com, registered which at Barlborough provides NMC nurse a or real include an feel HCPC flexible good registered or factor call rosters 07580 ODP for which the 018971. and whole able enhance to team. work-life
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•
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to hear
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from
and
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and aims to address patient complacency, correct myths and in their homes to determine if they should consult a hand specialist.
If you are a part one registered NMC nurse or an HCPC registered ODP and able to
We
demonstrate misinformation and highlight
welcome
competencies the Tabletop Test
applications from
in your
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speciality
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we would
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like
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to hear
area
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Watching Education Unfold encourages people who think they may
• demonstrate competencies in your speciality we would like to hear from you.
there
We Dupuytren’s welcome contracture
is very
applications is a progressive hand
generous relocation
from condition practitioners that affects have
package
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available
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local been area diagnosed
you.
and with DC but have not been
an estimated 14 million Americans
treated to talk to a hand specialist.
We there welcome is a very applications generous To apply or relocation arrange from practitioners an package informal chat outside available with of the to the team support local contact area you. and
Endo International plc (NASDAQ:
there is a very sonia.sanghvi@practiceplusgroup.com,
ENDP) announced recently the launch Media Buy
generous relocation package available or call to 07580 support 018971.
of its newest television commercial and disease awareness campaign,
you.
Watching Education Unfold. The campaign educates people about
Dupuytren’s contracture (DC), a progressive hand condition that affects
an estimated 14 million Americans.
“We’re using the voices and experiences of real patients to share
education about Dupuytren’s contracture and empower self-advocates,”
said Thomas Kolaras, Senior Vice President & General Manager, Medical
Therapeutics at Endo. “This authenticity resonates with people—they
To apply or arrange an informal chat with the team contact
sonia.sanghvi@practiceplusgroup.com,
To apply or arrange an informal chat with
or call
the
07580
team contact
doctors’ offices.
018971.
sonia.sanghvi@practiceplusgroup.com, To apply or arrange an informal chat with or call the 07580 team contact 018971.
About Dupuytren’s Contracture
sonia.sanghvi@practiceplusgroup.com, or call 07580 018971.
can see themselves in the campaign and may consider talking to a hand
specialist about their options.”
“My patients with Dupuytren’s contracture tend to cope with the
condition for longer than necessary because of conflicting information
that’s out there,” said Dr. Heidi Coryell Shors, an orthopedic and hand
surgery specialist. “In my opinion, Endo’s commercial and campaign
could help a lot of people who needlessly suffer from the condition.”
Elway-to-Everyday Evolution
Watching Education Unfold follows Endo’s previous awareness
campaign, which featured DC patient John Elway. After grabbing the
public’s attention with the help of the football legend, Endo is focusing
on everyday people who have DC.
The new campaign brings to light people’s hesitations and aims to
correct misconceptions that may prevent many from seeking treatment.
The 30- and 15-second commercials will run nationally on broadcast
TV (including networks like ESPN and USA and during programs such as
“Good Morning America” and “CBS Evening News”), streaming services
(including Hulu and Discovery+) and online. Watch here: https://www.
factsonhand.com/#watch-now
The campaign also includes digital and search advertising, social media
accounts and ads on platforms where patients are active, a digital
partnership with Conde Nast, content on health-focused websites
(including WebMD and Everyday Health) and educational materials in
DC is a lifelong condition that may get worse over time. It’s caused by
a buildup of collagen in the hand, which forms a rope-like cord that
pulls fingers toward the palm so they can’t be straightened. As DC
progresses, it may become difficult for individuals to use their hand(s)
for daily tasks and activities.
www.endo.com
When responding to articles please quote ‘OTJ’
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 19

Distalmotion raises $90M to accelerate adoption
of surgical robot Dexter
Distalmotion announced recently the closing of a USD 90 million Series E financing to support the global commercialization of its surgical robot
Dexter. RevivalHealthcare Capital (Revival) led the round with participation from 415 CAPITAL (415), as well as existinginvestors.
CE-marked Dexter shifts the paradigm of robotic surgery by bringing the surgeon back into the sterile field, allowing direct patient access at all
times and integrating proven laparoscopic workflows into the robotic setup. This novel, user-centric approach makes the surgeon the focal point
of the procedure, reducing complexity and delivering sought-after simplicity and versatility to the market for robotic surgery.
“Dexter combines the best of both worlds – laparoscopy and robotics – to make sense of robotic surgery,” said Distalmotion CEO Michael Friedrich.
“By addressing essential problems that operating room teams face, we can deliver on our mission to fast-track widespread adoption of robotic
surgery in minimally invasive care. We are thrilled to have found the best-fitting partners to execute and deliver on this global purpose.”
The investment follows the successful completion of Dexter’s first clinical cases and aims to accelerate the Swiss company’s commercial scaling.
Leading European hospitals are spearheading the development of procedure guidelines and training protocols for robotic surgery with Dexter as
part of clinical studies and an Early Adopter Program (EAP). The company will also work closely with the U.S Food and Drug
Administration (FDA) on a US submission supported by the financing.
“This is a fundamentally new approach to robotic surgery,” said Prof. Dieter Hahnloser, who heads colorectal surgery at Lausanne University
Hospital and performed the worldwide first general surgery procedure with Dexter in 2021. “Dexter’s open platform and the ability to switch
quickly between standard laparoscopy and the robot give me an added sense of control and the freedom of choice to use the best instruments
available for the job. To have these benefits while remaining sterile, with direct access to patient and robot, indicates Dexter can be a gamechanger
in ORs around the world.”
In addition to financial backing, Revival will contribute hands-on leadership as the company gears up for growth: Revival Chairman Rick Anderson
will join the Distalmotion board as Chairman, while President Lauren Forshey will join as an observer.
“The market is overdue for a fundamentally new approach to robotic surgery, where the mindset needs to be about ‘the surgeon’s robot,’ not
molding ‘the robot’s surgeon,’” said Rick Anderson, Revival Chairman and incoming Chairman of Distalmotion. “Dexter is designed to work the way
surgeons and OR teams work: patient focused and user-centric, providing necessary patient access and optimal tools for every step of the way.
We are excited to deliver this powerful value proposition to surgeons, OR teams,and patients worldwide.”
For further information, visit: dexter.surgery and follow us on LinkedIn and Twitter: @Distalmotion
20 THE OPERATING THEATRE JOURNAL www.otjonline.com

The Operating Theatre Journal
Discovering the many more pages available online @ www.otjonline.com
New data on drug metabolism and
distribution in the eye
One of the most comprehensive ocular pharmacokinetic studies including metabolism so far provides valuable information
for ocular drug development.
Severe visual illnesses are increasing in our society, and effective
treatments are missing for diseases as age-related macular
degeneration, diabetic retinopathy, and glaucoma. Both industry and
academia are highly interested to advance ocular drug discovery and
development. Ocular pharmacokinetics is a key science in this process,
and knowledge of drug metabolism and distribution in the eye is
required. However, information on drug-metabolizing enzymes is only
sparsely available and new insights in this field will benefit the current
and future development of ocular therapies.
Researchers from the School of Pharmacy at the University of Eastern
Finland in collaboration with Boehringer Ingelheim have recently
published one of the most comprehensive ocular pharmacokinetic
studies that investigated the metabolism of four drugs in the rabbit
eye (acetaminophen, brimonidine, cefuroxime axetil, sunitinib). The
drugs were applied via two administration routes (intracameral and
intravitreal) and concentrations of both parent drug and the main
metabolite were analyzed in six different ocular tissues. Finally,
pharmacokinetic drug and metabolite profiles were obtained and
analyzed.
Ocular drug metabolism cannot be directly predicted from hepatic
metabolism data
The metabolism of a drug is usually assessed based on its behaviour
in the liver. However, this study showed that activities for many
metabolic enzymes are low in the ocular tissues and their profiles are
different from those in the liver. Thus, ocular metabolism cannot be
directly predicted from the hepatic metabolism data that are generally
produced during drug development. Only esterases seem to have a
major impact on ocular drug clearance and not the other enzymes.
However, the latter may contribute to ocular drug toxicity especially
important for long-acting drug formulations. In conclusion, the present
study provides valuable and drug-specific information on ocular drug
metabolism and pharmacokinetics for advancing ophthalmic drug
development.
Scheme of the research on the intracameral and intravitreal pharmacokinetics of drugs and their
metabolites formation.
Photographer: Eva del Amo Páez
The study was supported by the EU-ITN project OCUTHER (H2020- MSCA-
ITN-2016, grant number 722717) as well as the Doctoral Programme and
the strategic funding of the University of Eastern Finland.
For further information, please contact:
Senior Researcher Eva del Amo, E-mail. eva.delamo@uef.fi
Research article: del Amo EM, Hammid A, Tausch M, Toropainen E,
Sadeghi A, Valtari A, Puranen J, Reinisalo M, Ruponen M, Urtti A,
Sauer A, Honkakoski P. Ocular metabolism and distribution of drugs
in the rabbit eye: quantitative assessment after intracameral and
intravitreal administrations. Int J Pharm 613: 121361, 2022. https://doi.
org/10.1016/j.ijpharm.2021.121361
www.facebook.com/TheOTJ
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 21

Timestrip Introduces its First
Micro Data Logger
The New Way of Reading Logged
Temperature Data
Timestrip®, the developer of
smart indicator technology, has
introduced its first temperature
data logger – the TL520. This
compact and economical ‘micro
data logger’ provides alerts when
temperatures breach set limits,
and allows the logged data to
be downloaded to an app for
investigation and analysis.
Simpler and easier to use than
conventional data loggers, the
TL520 requires minimal training in
use, and can be used at any point
in the cold chain.
The TL520 is a single use
device providing an immediate
irreversible indication of overand
under-temperature conditions using built-in LED lights. Accuracy is
quoted as ±0.5 degC over the normal operating range.
A novel feature of the TL520 is that stored data can be sent wirelessly
to an accompanying app. for investigation and analysis using built-in
NFC technology. No computer is required as the data downloads to
any compatible mobile device, and both iOS and Android devices are
supported.
The 2-8 degC default settings make the TL520 ideal for monitoring
cold chain (refrigerated) temperatures in the storage and transport of
sensitive products. Pharmaceuticals, blood, vaccines and food products
are typical end use applications.
“The new micro logger provides many of the benefits of bulky,
traditional data loggers, yet is much simpler to use and is small enough
to store with many products during transport and storage“, said Nora
Murphy, Commercial Director of Timestrip.
The TL520 is now available from Timestrip and its distributors.
timestrip.com
When responding to articles please quote ‘OTJ’
OMFS Daniel Van Gijn awarded
Ellison-Cliffe Travelling Fellowship
Daniel Van Gijn, an ST7 specialist registrar in oral and maxillofacial at
the Royal Surrey NHS Foundation Trust, is one of the five successful
applicants for the Royal Society of Medicine (RSM) Ellison-Cliffe
Travelling Fellowships.
With the support of the travelling fellowship, he will be spending a
year in Australia at the Chris O’Brien Lifehouse (COBH). Daniel has a
fellowship in head and neck surgery and post-ablative microvascular
reconstruction at the COBH in Sydney.
“The surgical opportunities presented to me at the Chris O’Brien
Lifehouse will equip me to continue my career as a consultant head
and neck surgeon,” Daniel commented.
Professor of OMFS Kathy Fan said she was delighted that Daniel Van Gijn
has won the award.
RSM Trustee and Chair of the Ellison-Cliffe Charitable Trust Dr Melita
Irving says she looks forward to hearing how the fellows have had an
impact on patient care.
Daniel recently published the new Oxford Handbook of Head and Neck
Anatomy.
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:
admin@lawrand.com
TCI & BIS Practicum
A highly practical one day course made of lectures,
demos, and workshops.
A day aimed at Specialist Trainees,
Post-fellowship Trainees and Consultants.
Thursday 3 rd March 2022
Register: www.royalmarsden.nhs.uk/studydays
22 THE OPERATING THEATRE JOURNAL www.otjonline.com

www.OperatinggTheatreJobs.com
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 admin@lawrand.com Issue 377 February 2022 23

Are you sure you are allergic to penicillin? Professionals
and patients are urged to double-check
Published on 20 January 2022doi: 10.3310/alert_48839
Millions of people in the UK have penicillin allergy recorded in their
medical notes. Many of them are not truly allergic. New research
highlights the importance of both doctors and patients discussing
recorded penicillin allergies.
Penicillins are first-line treatment for many infections. People with a
penicillin allergy listed in their medical records will not receive them.
This keeps people with a true allergy safe. However, it means that
people who are not allergic will receive second choice antibiotics if
their notes are incorrect. This can mean longer hospital stays and more
risk of antibiotic-resistant bacteria.
This research explored patients’ and physicians’ views on penicillin
allergy. It found that both groups were often unsure if the allergy was
true. There was also confusion over the difference between a side
effect and an allergy. Patients tended not to question the allergy once
it was in their notes. Similarly, doctors were often reluctant to override
the allergy record in case of an allergic reaction.
Having penicillin allergy wrongly included in medical notes has negative
consequences. The study is part of a larger project designed to see if
testing for penicillin allergy and removing incorrect records improves
patient health outcomes and antibiotic use.
Currently, few GPs have access to testing for penicillin allergy or know
how to refer people. These results show the need for more widespread
communication about testing. More testing would mean that many
people could safely have penicillin allergy removed from their records.
Further information on penicillin allergy is available on the NHS website.
What’s the issue?
Antibiotics, particularly penicillins, are used to treat bacterial
infections. Around 1 in 15 people have an allergy to antibiotics listed
in their medical records. Three million people in the UK are unable to
access highly effective penicillins.
Most reported reactions to penicillins are mild. However, true allergic
reactions can be severe, and include breathing difficulties and loss of
consciousness.
Previous research has suggested that as few as 1 in 10 people with
a penicillin allergy listed in their medical records are truly allergic.
Occasionally, symptoms of the infection being treated (such as a rash)
can be confused with an allergic reaction. Or side effects might be
thought to be an allergy. The most common side effects of antibiotics
affect the digestive system (vomiting, nausea, diarrhoea). They are
usually mild and stop when treatment finishes. Symptoms or side effects
can lead to an allergy being incorrectly listed in medical records.
Penicillin is an effective first-choice antibiotic. People with penicillin
allergy listed in their records are given the next best medication.
Allergies are included in medical records to safeguard people against
having a reaction. However, having a penicillin allergy listed in medical
records is linked with negative outcomes. They include longer hospital
stays, more antibiotic prescriptions, an increased risk both of surgicalsite
infection and infection with antibiotic-resistant superbugs, and
death. It is therefore important to ensure the information is accurate.
The National Institute for Health and Clinical Excellence (NICE) asks
clinicians to ‘double check’ patients with a penicillin allergy recorded.
This is because another antibiotic might not be as effective for their
illness. In addition, many alternatives to penicillin (broad-spectrum
antibiotics) act against a wider range of bacteria. They are more likely
to promote antibiotic resistance. Progress towards new antibiotics has
been slow.
This study explored clinicians’ and patients’ views of penicillin allergy,
and of testing for it.
What’s new?
Researchers interviewed 31 patients with documented penicillin
allergy in the North of England. They also interviewed 19 primary care
physicians both with and without experience of dealing with penicillin
allergy.
Five main themes emerged from the interviews.
1. Patients’ understanding of allergy
Many people were diagnosed with allergy a long time ago. They were
more convinced of their allergy if symptoms occurred immediately
after taking penicillin, or were very severe. Some questioned if allergy
was hereditary. Many were unclear about the difference between side
effects and allergies.
2. Impact of allergy on patients
People who believed themselves to have a true allergy typically
reminded healthcare professionals of their allergy and checked
medicines for penicillin. People who were at risk of recurrent infections
worried more about running out of antibiotic options than those who
rarely took antibiotics.
3. Doctor-patient interaction
Most patients accepted the diagnosis of allergy without question and
did not discuss it with their physician. Some would take advice from
their physician about whether allergy testing would be beneficial.
4. Doctors’ uncertainties about diagnoses
Doctors said they routinely checked medical records for allergies, and
valued reminders on the electronic system. Some also checked with
the patient. Others noted that the on-screen system did not distinguish
between side effects and allergies. This made several doctors doubt
allergy status. Physicians also queried how the diagnosis was originally
made and whether it was based on family history.
Most doctors were aware of the over-diagnosis of penicillin allergy. A
severe reaction (anaphylaxis) was clear-cut but some symptoms (such
as rash) made allergy difficult to diagnose.
5. Prescribing decisions
Doctors did not find it difficult to source alternative antibiotics when
there was only one allergy. Even when they doubted the recorded
allergy, they often avoided prescribing penicillin. Some doctors
challenged the recorded allergy, for instance where penicillin was the
best choice. They discussed it with the patient and came to a decision
together after reviewing the medical history.
Some doctors had referred patients for allergy tests, though most were
uncertain about the criteria needed and what testing involved. Doctors
rarely initiated discussions about the negative consequences of having a
penicillin allergy recorded in medical notes. They said this was because
it would not affect the patients’ day-to-day lives.
The research team concluded that both doctors and patients should be
more aware of the negative consequences of having penicillin allergy
incorrectly included in medical notes.
Why is this important?
Diagnosing penicillin allergy is clinically difficult and medical records
are often incomplete. Doctors tend not to prescribe penicillin if an
allergy is noted, even when they doubt it is a true allergy.
The interviews identified gaps in patients’ understanding of penicillin
allergy and how it differs from side effects. More discussions between
doctors and patients would be helpful. (Continues on page 25)
24 THE OPERATING THEATRE JOURNAL www.otjonline.com

(Continued)
New Type of Medical Helicopter
Provides Intensive Care in Transit
The research concluded that doctors as well as patients need to be
convinced of the negative consequences of keeping an inaccurate
diagnosis in records. Some felt it was an issue in the hospital setting,
rather than in primary care. Highlighting the negative impacts could
lead to more open discussions between patients and their GPs.
The benefits of testing for penicillin allergy also need to be stressed,
the study found. Doctors need more information about how to arrange
testing for patients.
What’s next?
Both doctors and patients need to understand the potential harms
associated with having penicillin allergy wrongly noted in medical
records. Healthcare professionals could be encouraged to supply more
detail in medical records about the initial reaction to penicillin. They
also need support to de-label low-risk patients in primary care. Decision
aids and algorithms might help to establish whether a medication has
caused harm, and whether testing is needed.
The current study was part of a larger project called ALABAMA (Allergy
Antibiotics and Microbial Resistance). Other research by the same team
is aiming to find clinically- and cost-effective ways of correcting a false
record about penicillin allergy. As part of this work, the researchers
are looking to make allergy testing more efficient. It currently requires
two visits. The team are exploring ways of testing for allergy in a single
visit.
You may be interested to read
This NIHR Alert is based on: Wanat M, and others. Management of
penicillin allergy in primary care: a qualitative study with patients and
primary care physicians. BMC Family Practice 2021;22:112
Another paper from the same team: Wanat M, and others. Patient and
primary care physician perceptions of penicillin allergy testing and
subsequent use of penicillin-containing antibiotics: a qualitative study.
The Journal of Allergy and Clinical Immunology: In Practice 2019;7:1888-
1893
Funding: This work was funded by the NIHR under its Programme
Grants for Applied Research Programme.
Conflicts of Interest: The study authors declare no conflicts of interest.
Disclaimer: NIHR Alerts are not a substitute for professional medical
advice. They provide information about research which is funded or
supported by the NIHR. Please note that views expressed in NIHR Alerts
are those of the author(s) and reviewer(s) and not necessarily those of
the NHS, the NIHR or the Department of Health and Social Care.
Karolinska University Hospital will be the first in Sweden to have a new
type of medical helicopter that can provide the sickest patients with
advanced care, even in the air. The helicopter can bring patients from
all over the country to Karolinska.
A contract for the operation and delivery of an Agusta Westland 139
(AW 139) helicopter has been signed by the supplier, Babcock, and
Karolinska. Karolinska will get access to a temporary helicopter in
March, 2022, and at the beginning of 2023, the permanent helicopter
will be delivered.
- Karolinska will be the first hospital in Sweden to have this type of
helicopter, which is unique, as the on-board staff can provide the
sickest patients with on-board medical care in a way that has not been
possible until now, such as ECMO care, says Lars Falk, operational
manager of Intensive Care and Transport, and continues:
- With the new helicopter, we can reach hospitals faster because we
don’t have to reload like we do now when flying planes.
Another advantage of the AW 139, which is considerably larger, heavier,
and has much more space than a regular ambulance helicopter, is that
it is built to withstand very severe weather conditions.
- In addition, it has its own de-icing system that allows it to withstand
severe winter weather and storms. All in all, the helicopter basically
functions as a flying intensive care unit, says Lars Falk.
HideBabcock Agusta Westland (AW 139)
• Can fly with a total weight of 7 tonnes
• Rotor diameter is 13.8 metres
• Length, 16.7 metres
• Space for 4 staff and 1 patient on board
• Extra-large windows for maximum visibility during missions
GI Supply Receives CE Mark for its EverLift® Submucosal Lifting Agent
New EverLift® medical device now available to physicians
across Europe
GI Supply Inc. today announced its EverLift® Submucosal Lifting Agent
has been awarded a CE Mark and is now available for use by physicians
across Europe. EverLift is a new device for the lift of polyps, adenomas,
early-stage cancers and other gastrointestinal lesions prior to their
excision with a snare or other appropriate endoscopic device1.
EverLift facilitates endoscopic resection procedures such as endoscopic
mucosal resection (EMR) or endoscopic submucosal dissection (ESD),
during examinations in the upper and the lower gastrointestinal tract.
EverLift is GI Supply’s first medical device to be awarded a CE Mark
under the new EU Regulation 2017/745 on Medical Devices (MDR).
EverLift gained FDA clearance in October 2020.
EverLift is the only pre-filled Submucosal Lifting Agent available in
both 5mL and 10mL syringes, providing physicians with the flexibility
to use only what they need whether lifting small or large lesions. In
addition, the sterile pre-filled syringe reduces the time and infection
risk associated with preparing a hospital-mixed solution.
The darker blue colour of EverLift is used to identify the perimeter of
lesions enabling a safe and complete resection, reducing the risk of
recurrent lesions. Following resection of a lesion, the darker colour
helps endoscopists identify potential injuries to the muscle layer.
“Lifting agents aid in safer resections for patients. EverLift provides
a pliable yet reliable cushion for resection and darker blue hues. The
single serve dosing helps reduce waste for everyday polypectomies.” –
Dr. Taavi Reiss, Assistant Professor of Clinical Medicine LSU Health and
Director of Interventional GI Metropolitan Gastroenterology Associates.
EverLift is cellulose based, creating a hypertonic solution with an
absorption rate slower than other currently available agents2. EverLift
provides gastroenterologists with a long and stable lift during their
resection procedures.
“This is an effective lifting agent for endoscopic resection that is
offered in convenient and cost-effective packaging.” – Prof. Douglas
Rex, Director of Endoscopy at Indiana University Hospital, Indianapolis.
“The CE Mark for EverLift enables us to reach more physicians around
the world. Many gastroenterologists will be familiar with our Spot®
Ex Endoscopic Tattoo, and we have used our extensive experience in
injection solutions to develop a unique lifting agent which will enhance
their ability to safely resect lesions,” said GI Supply Senior Marketing
Manager Simon Humphrey-Adam.
View the product video here: bit.ly/OTJEverLift
Further information contact: Simon Humphrey-Adam, International
Marketing Manager, s.humphrey-adam@gi-supply.com, 07974 319 541
www.gi-supply.com.
1. EverLift Instruction for Use G55-006 Rev 08, Nov 2021; G59-007
Rev 07, Nov 2021
2. Based on ex-vivo bench top studies and not in clinical use.
Data on file
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 25

Smith+Nephew expands nextgeneration
handheld robotic-assisted
CORI Surgical System into total hip
arthroplasty with RI.HIP NAVIGATION
Smith+Nephew the global
medical technology business,
today announces the expansion
of indications on its CORI
Surgical System - the industry’s
most advanced and efficient1,*
handheld robotic solution in total
knee arthroplasty1,*,† - to now
include total hip arthroplasty
(THA). Smith+Nephew’s RI.HIP
NAVIGATION - designed to
help maximize accuracy and
reproducibility by delivering
patient-specific component
alignment for THA – is now
available for use on its CORI
System.
Last year, a new study concluded
that computer-guided technology
for THA significantly reduced the
risk of revision2 and increased
patient satisfaction2 when using
Smith+Nephew implants. The first
of its kind study used data from
the world’s largest arthroplasty
register (National Joint Registry
of England, Wales and Northern
Ireland) to investigate the effect
of computer-guided THA surgery
on implant survivorship.2 The
data reported on THA surgery
performed using Smith+Nephew
hip replacement components
implanted for osteoarthritis since
2003 and was presented at the
2021 World Arthroplasty Congress.
The results demonstrated:
• A significantly lower revision
rate at 10 years with computerguided
(1.06%) vs. conventional
THA (3.88%; p=0.005)2
• A 55% lower risk of revision
at 10 years with computerguided
vs. conventional THA
(p=0.038)2, and
• Significantly higher patient
satisfaction in the computerguided
group compared to
conventional THA (p=0.003)2
“The addition of RI.HIP
NAVIGATION on the CORI
System further strengthens
Smith+Nephew’s Real Intelligence
digital ecosystem and underscores
our commitment to advancing
clinical outcomes in total hip
arthroplasty,” said Randy Kilburn,
Executive Vice President &
General Manager, Reconstruction,
Robotics and Digital Surgery
for Smith+Nephew. “We look
forward to offering the possibility
of further improving patient
outcomes and satisfaction to a
broader surgeon community with
the rapidly expanding adoption of
our CORI Surgical System.”
Smith+Nephew’s
RI.HIP
NAVIGATION recently received
510(k) clearance from the
Smith+Nephew’s
RI.HIP NAVIGATION
United States Food and Drug
Administration for use on its
CORI Surgical System. Software
installations will start immediately
for a limited number of hospitals
and Ambulatory Surgery Centers
(ASCs) in the United States with
broad commercial availability
later in 2022. It will be introduced
in various European and Asia
Pacific markets once regulatory
authorizations are finalized.
To learn more about
Smith+Nephew’s Real Intelligence
ecosystem, please visit
www.real-intelligence.com
References
1. Smith+Nephew 2020. CORI and NAVIO
System Technical Specification
Comparison. Internal Report. ER0488
REV B.
2. Davis ET, McKinney KD, Kamali A, Kuljaca
S, Pagkalos J. Computer guided total hip
arthroplasty is associated with a reduced
risk of revision and increased patient
satisfaction. An analysis of a single
manufacturer acetabular components
from the National Joint Registry of
England, Wales, Northern Ireland and
the Isle of Man. Poster presented at:
World Arthroplasty Congress Virtual
Meeting; April 22-24, 2021
*Compared to conventional techniques
†Compared to NAVIO Surgical System
Trademark of Smith+Nephew. Certain
marks registered US Patent and Trademark
Office.
New €10 million
operating theatres open
in Bon Secours Cork
The hospital anticipates treating an additional 5,000 patients a year
Bon Secours Hospital Cork has opened two new operating theatres,
bringing its overall theatre capacity to 11, including one fully-integrated
laparoscopic theatre.
Part of a €10 million investment, the Cork hospital has become the
first hospital in Ireland to install an Olympus operating theatre which
will provide patients with access to fully integrated, state-of-the-art
general surgery procedures, including bariatric surgery to support the
fight against the increasing obesity rates across Ireland.
The hospital is creating 20 new positions to support the new theatres,
including surgeons, anaesthetists, nurses, and theatre support staff.
It expects to be able to treat 5,000 extra patients annually through the
additional capacity of the two new theatres.
Speaking at the opening, Taoiseach Micheál Martin said, “This is another
important milestone in the ongoing development of health services for
patients living in the region and further evidence of Bon Secours Cork’s
innovation and excellence in healthcare.
The additional theatre capacity will greatly benefit people living
across the Munster region at a time when the pandemic has put such
pressure on our health system. Bon Secours Health System’s continued
investment in world-class facilities and its expansion of vital services
are extremely welcome, and I congratulate them for their ongoing
commitment to technologically-advanced medical care.”
The expansion of the theatre capacity enables Bon Secours Hospital
Cork to treat more patients in a timely manner and react to patient
needs by providing access to more advanced technologies. It will also
enable the hospital to offer additional capacity to the public system to
assist with the existing overwhelming demand for quality healthcare
services.
Bon Secours Cork is Ireland’s largest private hospital and is also one of
the largest private hospitals in Europe.
Source: Irish Medical Times
Where Are You Now?
Did YOU train as a Technician, ODA or ODP? City & Guilds, NVQ ?
Where has you career path taken you?
Are you still in theatres or have you moved to pastures new?
We’d love to hear from you regards your career path, which we
hope can inspire others.
Please send us your career path in around 500 words which we’ll
publish in a future issue of The OTJ. We won’t use your name when
publishing your career summary, just let us know your initials or
even a pseudonym (unless you give us permission to use your name).
We look forward to sharing you progression since qualifying with
our readers.
Please send your summary in an email with ‘Career’ in the subject
heading to: admin@otjonline.com
Are You Linkedin ?
Join our Group
The Operating Theatre Journal
in TM
26 THE OPERATING THEATRE JOURNAL www.otjonline.com

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Karolinska University Hospital First to Give Stem Cells to Foetus with
Severe Osteoporosis
A new treatment is being trialled to help children born with a severe
variant of osteoporosis, osteogenesis imperfecta. It is the first clinical
trial in the world in which bone-forming stem cells are given before
birth. The hope is that this will increase the child’s chances of building
a functioning skeleton.
Osteogenesis imperfecta is a congenital genetic disorder in which
the collagen type 1 protein is defective, or not produced in sufficient
amounts, preventing the bones from storing enough calcium, and
growing strong. The skeleton is also remodelled too quickly, which
contributes to the weakness.
Those living with the severe form of the disease can, without treatment,
suffer hundreds of fractures in their lifetime. They may also suffer from
extreme hyperextension of ligaments, compressed vertebrae, and
severe pain.
- Now, the prognosis for children born with the disease is better,
because a drug exists. Surgery and regular visits to a physiotherapist
also help a lot. However, severe osteogenesis imperfecta still leads to
short stature and broken bones, although not to the same extent as in
the past, says Eva Åström, a doctor at the Astrid Lindgren Children’s
Hospital, and principal investigator for the BOOSTB4 study.
The severe form of osteogenesis imperfecta is very rare; in Sweden,
about 5 children a year are born with it.
On Thursday the 18th of November, the first prenatal (before birth)
transplant of bone-forming stem cells was performed in a patient with
“The severe measures osteogenesis Sir Bruce imperfecta. Keogh outlined The family during came his from speech Germany last night to
will Karolinska be instrumental University in Hospital supporting as part healthcare of the EU professionals BOOSTB4 collaboration. to identify
the early signs and enable them to act, Health Education England’s new
education - Previous and research training shows materials that will there be particularly is a good relevant chance that as will the a
clinical treatment network will be approach beneficial. to care The where theory professionals is that the and stem organisations cells will
work seek out together the skeleton across a where dened they geographical can help with area bone – this formation, helps to bring says
a Cecilia safe, Götherström, standardised and researcher equitable at approach the Karolinska to care. Institute, which is
developing this type of stem cell.
“As This a is college, the first we time have the updated treatment the national has been template given to for a foetus the Personal in this
Child way in Health a clinical Record trial, to but include another information part of for the parents same study, on how stem to cells tell
if of your this type child have is ill, been and for given health to 12 professionals, babies, without have complications.
recently launched
Paediatric Care Online (PCO-UK) – an online decision support tool,
providing - The reason specialist why we diagnostic want to give advice the to stem help cells ensure even children before get birth the is
right that fewer treatment of the at cells the earliest are filtered opportunity. out by the lungs, as foetuses have a
different kind of blood circulation, and have not yet started breathing
“To
normally.
support
Treatment
this, I
is
now
therefore
urge
likely
paediatricians
to be more
and
efficacious.
all healthcare
professionals to utilise the resources Sir Bruce has outlined. Collectively
Being able to influence the child’s bone formation as early in life as
we can slow down the grip of this deadly disease and reduce the number
possible is, of course, also beneficial, says Eva Åström.
of children who come face to face with it.”
Treatment with the stem cells for the foetus is carried out as an
Louise injection Silverton, via the umbilical Director cord for at Midwifery the Centre at for the Foetal Royal Medicine, College the of
Midwives, country’s only said: centre “Severe for sepsis national, can highly and does specialised kill. Though care in it this rare, field. it
can be catastrophic for pregnant and postnatal women.
- It’s the same type of procedure we use when a foetus needs a blood
transfusion, which is something we do 1 – 2 times a week, says Peter
“Sepsis Lindgren, remains operations a leading manager cause at of the maternal Centre for death. Foetal That Medicine. is why it is so
important that we do all we can to identify it as soon as possible so that
it Following can be treated. the procedure, It is also and important meticulous not monitoring forget newborn for 24 hours, babies both who
can mother succumb and son to were infection fine. very The quickly. baby has now been born, and will return
to Karolinska University Hospital to repeat the treatment at the age of
“Midwives 3 – 5 months. should certainly “think sepsis” where there is deterioration
in the health of either mother or baby. This means we need the right
number
So far, three
of midwives
unborn children
so that they
have
can
received
deliver
the
the
treatment,
best possible
which
care,
has
including
been approved
in the
by
postnatal
the Medical
period.
Products Agency and the Ethical Review
Authority. The research project is part of the Horizon 2020 programme,
the EU’s largest investment into research and innovation, and the
“Having Swedish the Research right Council. numbers of staff will also help to ensure continuity
of care and carer for women. Midwives who know the woman will be
better The Karolinska equipped Institute to spot changes is the sponsor in the woman’s of the clinical condition trial. and They identify are
problems manufactured such as at sepsis special developing.” laboratory Vecura at Karolinska University
Hospital.
Royal Oldham extension takes a step
closer to improve patient care for
general and colorectal surgery patients
Groundworks for a new extension to The Royal Oldham Hospital have
begun with a ground-breaking ceremony being held on 18 January.
The new development is part of the Greater Manchester Improving
Specialist Care programme and will enable the Royal Oldham Hospital
to operate as the hub site for high risk and emergency general and
colorectal surgery.
Construction works for the new £28m four-storey extension to the main
hospital building are well underway and existing structures including
the hospital’s old Adult Medicine building have been demolished to
make way for the new building.
Oldham Care Organisation Chief Officer, David Jago, said: “We are
delighted that great progress is being made on the new development.
Today marks an important milestone. We are one step closer to having
a new state-of-the-art theatre for emergency and colorectal surgery,
rehabilitation facilities and most importantly additional beds. These
new facilities will help us to support patients throughout Oldham and
Greater Manchester with serious colorectal conditions and ensure they
receive consistent, high-quality patient care.”
The new building has been designed by architects working alongside
clinicians, operational and support staff and patients to ensure every
detail is captured with patient wellbeing in mind.
The new building will have spacious patient day rooms and equipped
therapy spaces, and the two new 24-bedded general surgery wards will
be located on southern and western elevations to provide outwardlooking
views for patients, maximising natural light. It will also house a
new state-of-the-art theatre for emergency and colorectal surgery for
patients who have conditions affecting the colon and rectum.
Dr Jonathan Moise, Medical Director at The Royal Oldham Hospital, said:
Professor “I am delighted Helen Stokes-Lampard, and excited see Chair the of building the Royal work College underway. GPs, said: The
“Sepsis build will is house a huge wards worry and for facilities GPs as specifically initial symptoms designed can for be general similar
to and other specialist common colorectal illnesses, surgery and the patients. College The is additional putting a lot state of of effort the
into art operating helping family theatre doctors will recognise facilitate potential more laparoscopic sepsis and (“key-hole”)
ensure that
patients surgery to rapidly improve receive patients’ appropriate recovery assessment and experience and treatment. and shorten
hospital stays.”
“We have produced a toolkit, in partnership with NHS England, which
brings
Aside from
together
new state-of-the
existing guidance,
art facilities
training
and improved
materials
care
and
for general
patient
information
and colorectal
to
surgery
encourage
patients,
us all to
it is
‘think
hoped
sepsis,
that the
talk
development
sepsis and treat
will
sepsis’.
also bring many other benefits for the local economy and the people
“We of Greater are pleased Manchester to be working during the with construction NHS England phase to raise including awareness the
and creation improve of employment, outcomes for skills, patients. training It really and supply could chain save lives.” opportunities.
Anna Fiona McLoughlin, Crossley, Professional Senior Project Lead Manager for Acute, at DAY Emergency Project Management & Critical
Care Ltd said: at the “We RCN, are said: thrilled “Sepsis the is new a life-threatening extension is now condition underway and on-site early
identication and is a step closer is the to key providing to survival, improved but it patient can be care difcult facilities to diagnose to The
and Royal often Oldham symptoms Hospital can Estate. be mistaken for a u-like illness. This is why
raising awareness among carers, health care professionals and the
public DAY Project is so vital. Management Even though Ltd there are working has been alongside good progress IHP as to the improve main
diagnosis, contractor a and cohesive DAY Architectural national plan Ltd is as needed the lead to ensure designer that to healthcare deliver the
professionals new extension. are This supported is a fantastic and equipped milestone to to identify celebrate and as treat a team; sepsis we
early. are all excited to deliver this scheme on behalf of the Northern Care
Alliance NHS Foundation Trust”.
“If sepsis is not recognised quickly, it can lead to shock, multiple organ
failure Garry and Bowker, death, IHP which Regional is why Director, early detection said: “After is critical a detailed to start
treatment preconstruction, within design the hour. and Nurses business and case health process, care support it is fantastic workers, to
who reach see this their first patients major milestone a regular in the basis, construction and are often Phase the 4a rst at
healthcare The Royal Oldham worker to Hospital. see them, This are project well placed continues to recognise IHP’s long-standing the signs
of relationship sepsis early with and the raise Trust the at alarm. Royal If Oldham a person and has we signs are or proud symptoms
be
that delivering indicate this possible major investment infection, think at the ‘could hospital, this be which sepsis?’ will increase and act
fast capacity to raise and the provide alarm, significant wherever benefit you are. to patients and staff.”
https://www.england.nhs.uk/wp-content/uploads/2015/08/Sepsis-
The new unit expected to welcome its first patients in the summer of
Action-Plan-23.12.15-v1.pdf
2023. Source: Rochdale Online
twitter.com/OTJOnline
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 316 January 2017
28
7
THE OPERATING THEATRE JOURNAL www.otjonline.com

Europe’s oldest surviving operating theatre
Europe’s oldest surviving surgical theatre, nestled in London’s busy
streets, is marking 200 years since its first patient was treated with no
anaesthetics nor antiseptics.
Tucked away in the attic of a church adjacent to the original Saint
Thomas’ hospital, the women’s theatre was built in 1882, 67 years after
the men’s one, when the Industrial Revolution was in full swing and
plunged women into the workplace.
“Suddenly there were many more women in need of surgical
interventions, exactly the same as those of men,” Monica Walker,
curator of the forthcoming exhibition at Old Operating Theatre Museum
and Herb Garret , tells Efe.
A modest wooden amphitheater was erected in the church’s attic
connected to the main hospital through a door to deal with the growing
number of injuries.
To mark the theatre’s 200 year anniversary, visitors will be able to
learn about the fascinating place through true stories that have been
unearthed of surgeons, nurses, medical students and patients that
worked, studied or found themselves on the operating table.
Skeletons, atlas books on human anatomy, knives used for amputations
and 18th-century tools are on display.
Viewers can imagine how final-year medical students would gather in
the atmospheric amphitheater around the operating table perched in
the middle of the room.
All sorts of procedures would have been done publicly, including limb
amputations, mastectomies, lithotomies (removal of bladder stones)
and trepanations (drilling a hole into the skull to treat head trauma).
“Students would have arranged themselves around the chamber and
would have been wearing their everyday clothes,” Walker added.
“Many of them would have come with cigarettes, smoking was allowed
inside the operating room. You can imagine that this space would have
had a lot of smoke,” she said.
Hygiene was not high on the surgeon’s agenda.
They did not wash their hands before operating on patients and reused
their blood-soaked aprons, a hallmark of a prosperous career to be
worn with pride.
According to the museum’s investigations, these were the conditions
that Elizabeth Raigen, 60, would have surely encountered when she
entered the operating chamber at noon on April 29, 1824 to get a leg
amputation conducted by Dr. Travers using natural light pouring in
through the roof skylight.
She had been admitted to Saint Thomas’ Hospital ten days earlier with
an open fracture of the tibia and gangrene which would lead to death
if left untreated.
With no anaesthetic, Raigen endured twenty long minutes of an
operation that was usually done ten times faster in around two minutes.
The Lancet medical journal later published that Raigen emerged from
the operating room alive.
“The brandy and wine administered to her revived her a little,” the
journal noted, but she lost her life three days later.
Much to most people’s surprise today though, more patients survived
after a stint on the operating table – two out of three – at the old Saint
Thomas’ hospital.
Source: laprensa latina Claudia Sacrest
www.Operating peratingTheatre heatreJobs.com
A one-stop resource for ALL your theatre related Career opportunities
View the latest vacancies online !
Find out more 02921 680068 • e-mail admin@lawrand.com Issue 377 February 2022 29

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