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September 2013 Issue No. 276

ISSN 1747-728X

The Leading Independent Journal For ALL Operating Theatre Staff

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Surgical Safety Checklist is no magic bullet to prevent unsafe surgery, say researchers The principles underlying the Particularly disquieting was the finding A widely promoted checklist to reduce complications and deaths during surgery is not straightforward to implement in either high- or lowincome countries, says new research. It is especially unlikely to be used as intended in countries where the electricity supply is unreliable, there is a lack of basic materials such as gauze, and shifts can last for up to 36 hours. A study carried out by Dr EmmaLouise Aveling and Professor Mary Dixon-Woods in the Department of Health Sciences at the University of Leicester, and Peter McCulloch in the Nuffield Department of Surgical Science at the University of Oxford, has compared how the checklist was used in operating theatres in two English hospitals and one subSaharan African hospital. The results of the study, which was funded by a Higher Education Innovation Fund Impact Award, the Wellcome Trust, and the Department of Health Policy Research Programme, are published today in BMJ Open, an open-access online journal. They are likely to foster debate worldwide. Policymakers and the World Health Organization have supported the checklist since it was reported to have reduced the rate of deaths and complications by more than a third across eight diverse hospitals in different countries in a 2009 pilot study. Dr Aveling, who carried out the field research, says: “An important feature of the checklist is its claim to universality: it is meant to be as simple to use in a rural hospital in Namibia as it is in a private medical centre in New Zealand.” Now used in 1,800 institutions worldwide, the checklist combines checks for technical items such as administering of antibiotics and use of pulse oximeters (a device that is attached to the finger to measure oxygen to the brain) with non-technical items such as team introductions. Use of the checklist has been mandatory in UK hospitals since 2010. But so-called ‘never events’ - patient safety incidents that the

checklist is designed to catch - have continued to occur in the UK and around the world. The research team conducted extensive observations in operating theatres in the UK and an African country, and interviewed clinicians and managers to see whether the checklist was used at all, used properly and used fully. They found some similarities between the UK and African settings. Though many staff welcomed the checklist, they did complain about some items. And not all staff were wholly enthusiastic, or they were very resistant to using the checklist properly. If these individuals were in senior positions or very powerful in their local environments, their attitudes could undermine checks designed to promote teamwork and reduce hierarchies. Dr Aveling says: “The checklist was designed not only to improve patient safety by increasing the reliability of technical steps, but also by strengthening communication. But if checklist implementation is not handled well, it is precisely where technical and communication issues are most problematic that the checklist, by itself, is least likely to resolve them.” The research found that in the UK settings use of the checklist was high, although not 100%, for most procedures. In the African setting it was highly inconsistent - there, during staff shortages, emergencies or busy periods, the checklist was abandoned altogether. Checkboxes were ticked without tasks such as equipment counts being undertaken. Differences were particularly marked where material resources were concerned: there was a limited range of antibiotics and no hospital policy regarding their administration; there were also too few pulse oximeters yet operations were rarely cancelled if one was not available. Dr Aveling commented that: “Things we take for granted in the West reliable sterilisation, the availability of basic equipment - are rare in some low-income countries. This made the checklist difficult to implement and use correctly and completely.”

that poor checklist implementation in low-income countries might not only fail to reduce patient safety risks, but introduce new risks for staff and patients.

surgical checklist are good ones, but only now are we waking up to the serious challenges associated with implementation. On its own, the checklist is no magic bullet.”

The researchers cite the case of two staff members at the African hospital who were threatened at gunpoint and then arrested after a patient died during surgery from lack of oxygen to the brain. No pulse oximeter had been available, even though the checklist stipulates its use. Criminal charges were brought against one of the accused, who was not provided with legal representation for some weeks.

The team has made a number of recommendations that it hopes will make the checklist more effective across the world: surgical teams should be trained together on the use of the checklist, not separately within their disciplines; collection and feedback of data has to be improved, with further support if necessary; and senior staff need to be called on to act as ‘champions’ of the checklist where there is resistance to use. Most importantly, the checklist needs to be part of a broader, institution-wide campaign to improve patient safety, not just introduced in isolation.

Professor Dixon-Woods, who is a Wellcome Trust Senior Investigator in Society & Ethics, says: “Without adequate resources, efficient systems, and the right culture in place, hospitals adopting the checklist can introduce new risks for their staff and their patients. It is disturbing that the checklist can encourage unethical behaviour, as staff feel under pressure to tick the boxes even though they cannot comply.

Reference Aveling, EL et al. A qualitative study comparing experiences of the Surgical Safety Checklist in hospitals in high and low-income countries<http://bmjopen.>. BMJ Open; 16 Aug 2013

Health students put lifesaving formula to the test Health students from Birmingham City University will be taking to the fast lane next week when International Formula 1 event management company, FMCG International make a pit stop at the Universitys City South Campus.

Formula 1 pit teams represent the pinnacle of safety and efficiency where complex technical tasks must be completed precisely yet quickly. Whilst recognising that optimising team performance is key when delivering harm free care, Birmingham City University has introduced an innovative session where second year students from the Operating Department Practitioners (ODP) course will be trained by a team of pit crew experts on how to change the wheels on a racing car against the clock whilst ensuring they are fitted correctly and safely. Lecturer in Operating Department Practice, Paul Daly, explains: Delivering excellent care during surgery depends on having the right people with the right skills performing the right tasks at the right time, and this is exactly what F1 pit crews have perfected over the years. This will be a fantastic opportunity for the students to polish their skills and allow them to analyse their clinical practice in light of the F1 approach FMCG International will instil in them. This training will equip the students with transferable skills which will improve their performance in theatre and facilitate the delivery of the excellent care patients deserve and expect. It will teach students how to develop an effective team strategy, assign roles, set targets and analyse performance which will facilitate improvement in the future. For further information on Health courses at Birmingham City University please visit

The next issue copy deadline, Thursday 26th September 2013 All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY Tel: 02921 680068 Email: Website: The Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, and in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription. Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors. All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editor at the PO Box address. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2013 The Operating Theatre Journal is printed on FSC approved papers using biodegradable ink. Any waste from the production of the magazine is recycled.

Journal Printers: The Warwick Printing Co Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD Find out more 02921 680068 • e-mail

Issue 276

September 2013


Drones Could Give Heart Patients Fast Access to Defibrillators in Remote Areas In the future, aerial drones could be used to deliver defibrillators and other medical devices to patients in remote areas,according to Definetz, a German non-profit organization. The group is developing a medical drone called Defikopter. After being launched by a specialized smartphone app, the drone can fly a defibrillator to a heart attack victim, allowing for fast treatment. When an individual launches the Defikopter app, the app sends the GPS coordinates of the victim over a cellular data connection. Based on these coordinates, a drone will be dispatched to a person’s location. A drone can fly approximately 40 miles per hour. A single drone could traverse an area with a radius measuring six miles; it could potentially reach a patient anywhere in that area in 4.5 minutes or less.

How Lessons Learned in Aerospace can Benefit the Healthcare Industry When it comes to improving supply chain and inventory management the NHS could learn several valuable lessons from industry, says David Snelson from Waer Systems, a company that has a long history of implementing supply chain optimisation systems in the industrial sector. The pressure on the NHS is increasing, so improving procurement has to be a top priority for the NHS if it is to deliver a £20 billion saving by the end of the financial year 2014/2015. But without robust, flexible solutions, the targets to improve procurement simply won’t be met. The old maxim work smarter, not just harder has never been more relevant. To achieve these, the NHS would do well to look to the manufacturing industry, where supply chain optimisation and inventory management are key to maintaining cost-effectiveness. Take the Aerospace sector for example. In Aerospace and Defence, the exact location and movement history of high value, fast-moving assets such as containers, tooling, equipment and consumable items are now being routinely tracked in real time using Radio Frequency Identification (RFID). Over time, RFID technology and equipment have matured to a state where the range of practical and cost-saving applications is now much wider than it once was and in the healthcare industry in particular, there is an ever-expanding array of items where RFID tracking is now a tantalising proposition for smarter working. What is RFID? • RFID tags are a little like barcodes but a lot more sophisticated • They can be used for tracking more or less anything, from a freight container to a patient • Tags are embedded into the item they are tracking and can hold huge amounts of updatable information relating to the item they are on with information flowing both ways from a software programme in real time. • Ten years ago, RFID was not a viable proposition for tracking low cost items, as the tags themselves were quite costly, but the price has come down dramatically in the last few years, making RFID much more attractive. The precision and exacting standards of aerospace and defence have resulted in the evolution of this technology over many years and there are many clear and obvious applications for the technology in healthcare organisations, for example:

Aerial drones could provide a new means of delivering medical devices like defibrillators. Image credit: Height Tech While the invention has received praise from medical services in Germany, the system is still under development. As of now, Definetz and its partner Height Tech haven’t issued further information about the release of the device. “We’ll have to see how much these drones can help,” notes one representative for the German emergency services union. According to one German news site, the system will carry a price tag of $26,000. For now, using the device could be a problem. Since all unmanned flying vehicles in Germany must be supervised, an automated aerial drone would not be legal under existing laws. Source: Qmed

The UK ODP Message Group Joining is easy, just send an e-mail, stating your name, e-mail address, position and Hospital to:

Replenishment Ordering: although Trust ordering systems are often integrated with NHS supply chains, many of them are not at all well integrated with the systems that are in place to actually control the inventory locally on Trust premises. Patient-Level Costing: systems that are designed to support patient-level costing and patient administration are often limited in their effectiveness because in many cases, they lack a quick and straightforward method of recording patient-level consumption. Manual documentation and data input are still used extensively throughout the NHS. Surgical Loan Kits because of the continuously increasing variety of materials and services being offered to patients by NHS Trusts, sourcing the complex array of materials presents a number of challenges. Trusts have begun to use third party suppliers to provide kits of material on loan for specific operations which helps to deal with a lot of the complexity, however, it does bring with it a number of new issues: • The contents of the Surgical Loan Kits are not accurately listed anywhere on the Trusts systems as the kit is treated as a single item, so the Trust isnt fully in control of what should be in the kits. • Recording the materials taken out of the loan kits in theatres is completely manual which is time consuming and can naturally lead to human error. • As a result there are relatively frequent discrepancies between what Trusts think they have used and what the suppliers of the kits claim have been used, giving rise to significant wastage of resources and financial loss. All A of these examples have solutions. The problem, however, is that off-the-shelf software often isnt flexible enough to solve these specific problems, causing headaches and putting a strain on resources by rrequiring excessive training. Smaller, more agile software developers like Waer can solve these problems bbecause of the flexibility of their products and their proven track record with global organisations in the eexacting Aerospace and Defence industries. SSupply chain management is a fast moving industry and with technologies such as RFID, for example, now a much more affordable proposition, the opportunities for improved supply chain visibility and vastly iimproved management are there for the taking.


Inventory Management: each NHS Trust has a complex network of equipment, often stored in multiple locations with a variety of suppliers, sometimes for the same item, i.e: Trust A has two hospitals as well as several separate storage locations. At any one time the Trust is not necessarily sure what quantity they have of what items at any particular location. This means that there are a lot of error-prone human processes involved to try and replenish the stock from the correct location, and let the supplier know stock is low so as to avoid a stock-out.

FFor example, return on investment on Waer Systems projects is typically realised within two to four months of go-live, with on-going savings then becoming available either for investment in other areas, m or to lower the levels of pre-existing budgets while maintaining service improvements. With the NHS o iimprovement targets looming ever closer, this has to be good news. FFor more information contact: David Snelson, Sales Director on 01903 768010 / D


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Anetic Aid: factory expansion, product news and so much more! Theatre Equipment Specialist Anetic Aid has just published the latest edition of its magazine ‘Inside Theatre’. Among the headlines is the news of expansion at the company’s Portsmouth manufacturing facility – a move which will enable increased production capacity in the future and has already led to the creation of new jobs. The factory is where Anetic Aid’s QA3 Patient Trolley System, QA4 Day Surgery System and all of its stainless steel furniture range is made. The casing and stand for the new AT4 Tourniquet System is also designed and built at the two acre site. The AT4 is one of the key products featured in ‘Inside Theatre’, along with Anetic Aid’s recently expanded range of tourniquet cuffs. There are regular and special six-use versions available – the latter featuring a number of new paediatric cuffs specially designed for use with very young babies. Also in the spotlight in this edition is Trulife: Anetic Aid is the sole UK distributor for this pressure care specialist’s products and the article looks back at the Dublin-based company’s history and details a DVD it has released on products and techniques for effective pressure care in theatre. There are also features on the Independent Health Group and the increasing trend to offer surgical services in the community and on the use of lithotomy stirrups (If you want know the origin of the word ‘lithotomy’ – see page 5!) Copies of Inside Theatre are currently being mailed to hospital departments all over the country, so look out for it – or if you would like to request a copy, call 01943 878647 or When responding to articles please quote ‘OTJ’ email

Find out more about Fukuda Denshi at the 27th Annual BACCN Conference Fukuda Denshi is a leading supplier of advanced patient monitoring and user-configurable clinical information management systems. The company are attending the 27th Annual BACCN Conference being held at the Southport Theatre and Convention Centre on 16th & 17th September 2013. This year’s BACCN Conference is titled “The Cost of Caring: Resilience and Sustainability in Critical Care” and aims to cover current issues that arise from working in critical care, including practice, education, management and research. Fukuda Denshi will be attending the event with their DS-8500 high end critical care monitor incorporating Fukuda Denshi’s most intelligent user interface. It allows users to tailor the monitor to meet their specific requirements by offering a full suite of modules. The DS-8500 is highly versatile and can be mounted to suit all Bedside Environments. In addition, all patient data can be collected and viewed at the bedside or central station with its seamless patient record transfer from monitor to monitor via an HS 8000 super module. Also on show will be Fukuda Denshi’s MetaVision Clinical Information System, the MVICU, which is specifically designed for critical care use, and their DS7100 multi-parameter configured bedside monitor and DS-7200 patient bedside monitor - with hardware and telemetry connectivity. A warm welcome awaits all visitors to the Fukuda Denshi stand, where product demonstrations and further product information will be available. For further information, please telephone the company on 01483 728065. Fukuda Denshi: Healthcare bound by technology.

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Issue 276

September 2013



JUST because you are born in a stable does not make you a horse – and the same principle applies to the qualifications we provide.

Medical device industry personnel entering and assisting within theatres will, on successful completion of our course, be able to:

• Identify and comply with the health and safety requirements of the hospital within which they are working

Our healthcare training programmes are approved by relevant organisations including Government awarding bodies in the United Kingdom, the Royal College of Physicians and Surgeons Glasgow, and other professional bodies and healthcare stakeholders.

• Demonstrate in the hospital setting the knowledge and skills required when working in the operating theatre environment which encompasses the principles of safe practice and includes theatre etiquette, protocols and procedures.

• Apply the principles of standard precautions and infection control within the operating department

However, the fact they are recognised does not, in of itself, make our qualifications the best on the market – although we are proud of our association with some of the biggest and best companies and bodies in Europe.

• Identify the range of health and safety requirements required by Hospitals

Take HC Skills International’s Operating Theatre Access qualification. The reason it stands apart from others on the market in the UK, Europe and beyond because it develops the knowledge and skills which operating theatre managements expect of medical device industry personnel entering, assisting and providing verbal/technical input within operating theatre departments. It also blends practical, online and theoretical learning in a manner that ensures all relevant competences are comprehensively covered. Some healthcare organisations provide generic training of questionable quality that does not provide the evidence that professional competence or excellence has been achieved. Some of them provide low-cost, online-only learning programmes that leave out critical practical aspects altogether. We do not subscribe to this approach. Hence the horse analogy in the introductory paragraph. Just because you provide training does not mean you are a credible or reputable training provider. To us, robust examination and practical application, linked to a regulated qualification, is the only way to achieve professional standards and practical goals – AND provide a stake in the process. The purpose of our theatre access qualification is to orientate delegates to accepted departmental protocols and best practice for those entering the operating theatre or working in the operating theatre environment.


• Demonstrate in the clinical setting their personal ability to comply with the principles of standard precautions and infection control within the operating department. • Plan, implement and evaluate a product sales support session in which they demonstrate a piece of equipment for which they have sales and backup responsibility . To achieve this qualification, delegates must participate in practical and theoretical assessments. This means they have to:

The assessment process has been designed to ensure that each assessment criterion covers the full range of issues taught on the programme in such a way that candidates are required both to demonstrate their knowledge of the issues, interpret that knowledge in a reflective practice exercise and apply the knowledge in a clinical situation. All the HC Skills mentors have considerable experience of teaching and assessing on the programme. They also serve as a support and quality control network for lecturers and assessors in their own disciplines. Other specialists are also available on each course to provide support for peers and students in other disciplines. ©HC Skills International Ltd

1. Complete a comprehensive written assessment of the principles of safe practice within the operating department, using a risk management approach and providing reasoned arguments for decisions.

HC Skills International is an approved education centre delivering a range of externally validated, competencebased qualifications to the medical profession and healthcare industry that are internationally recognised.

2. Undergo a multiple-choice questionnaire covering all aspects of the taught Theatre Skills unit and its pre-course reading.

The company aims to guarantee the future of patient safety and the integrity of medical standards, through credible professional qualifications that are fully accredited and validated.

3. Demonstrate personal competencies in an actual hospital theatre under simulated conditions. Medical device industry personnel required to enter and assist within theatres will, if successful, meet the needs of operating theatre management and their employers by ensuring that all who enter the operating theatre are competent in the principles of safe theatre practice. They will also be able to: • Apply the principles of safe practice within the operating theatre environment • Identify and take appropriate action to manage the risks and potential hazards associated with the theatre environment


All those who successfully complete HC Skills’ courses are able to confidently demonstrate a level of competence that meets all relevant ethical, regulatory and professional requirements. HC Skills’ group of dedicated healthcare professionals is based at the Golden Jubilee National Hospital in Clydebank, near Glasgow – which is also home to the Beardmore Centre for Health Science and Beardmore Hotel – and at the company’s sister office in Madrid, Spain. Further information: Tel: 0141 951 5646 +44 7785733842 Twitter: @Di_Irvine When responding please quote ‘OTJ’

NICE Guidance supports the case to adopt Inditherm patient warming systems in the NHS • Clinical evidence supports Inditherm’s effectiveness at preventing hypothermia • Annual cost savings of £9800 per Operating Theatre • Additional savings from reductions in post-operative infections, energy usage and clinical waste

Contact any of our Medical team today for further information or a free trial, on +44 (0) 1709 761000 or email:, and quote Ref: MTG0811

The new standard in patient warming Full guidance can be found at

Should we change our attitude towards ‘never events’? Rather than categorising some adverse incidents as ‘never events’, we should ensure we learn from all medical errors Twenty-five errors in the health service are considered so intolerable and inexcusable that they have been designated ‘never events’. They include wrong-site surgery, retained foreign objects and administering chemotherapy by the wrong route. When a never event occurs, the organisation concerned must follow national procedures for reporting and investigating what happened and may pay a significant financial penalty. The object of the policy introduced in 2009 is to encourage greater organisational focus on specific serious safety issues. The problem with categorising certain incidents as never events is that it may divert attention from the most important goal of improving patient safety across the board. The term is also misleading because these events do occur, usually because of a combination of chance and human error, factors that can never be totally eliminated. In his positively received report into NHS patient safety Professor Don Berwick states: “’Zero Harm’ is a bold and worthy aspiration, [but] the scientifically correct goal is ‘continual reduction’. All in the NHS should understand that safety is a continually emerging property, and that the battle for safety is never ‘won’; rather, it is always in progress.” In May 2013 a BBC investigation identified 762 never events in four years, including 322 retained items and 73 misplaced nasogastric feeding tubes. I do not believe the categorisation never events is helpful. This is not to dismiss the distress these errors cause to patients and their families, but the term and the financial penalties create a stigma for individuals and organisations, which may not be conducive to a culture that should promote reporting and learning from mistakes.

One example is where patients have been given a drug, such as penicillin, to which they have a known allergy. The consequences of this could be anaphylactic shock and even death and in many cases the error could have been prevented by taking and recording of a medical history, checking records before administering medication and checking if the patient is wearing a red wristband. These preventable errors must be treated as seriously as a never event but there is a risk they may not get the same attention. Medicine, even when properly and carefully practised, is not a zero-harm or a zero-risk profession. Preventable things can and do go wrong, sometimes with severe consequences for patients and to the distress of the healthcare professionals involved. Berwick argues there is a need for a transparent culture within the NHS where mistakes are reported and learning is shared to improve patient safety. Patients who have suffered harm because of any medical error should rightly expect that what happened to them has been the subject of a thorough investigation to determine what happened, why and what lessons have to be learned. Wouldn’t it be better to concentrate on this than on determining whether an incident classifies as a never event? Dr Christine Tomkins is chief executive of the MDU This article was first published by Guardian Professional – Sept 2013.

London Trauma Conference

When our members, who are 50% of UK GPs and hospital doctors, approach us for advice about what to do if there has been a mistake in a patient’s care or treatment, we advise them to ensure the patient receives a sincere apology, together with an explanation of what went wrong and how it will be put right. Irrespective of whether the incident was a never event, it is vital that there is a full investigation and that steps are taken to avoid the incident happening again.

10th - 14th December 2013

Focus on avoiding all preventable errors For patients who are harmed, the last thing on their minds is probably whether it was a never event. There are incidents in which patients are harmed that fall outside the classification.

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Issue 276

September 2013


Xograph supply ‘ideal C-Arm’ to Merlin Park Hospital, Galway Leading independent medical equipment supplier Xograph Healthcare has recently completed the delivery and handover of a Ziehm Vision R SmartVascular mobile C-Arm to Merlin Park Hospital, Galway, Republic of Ireland. The foundation stone for the Merlin Park Hospital, previously called the Western Regional Sanatorium, was laid in the 80 acre estate in 1948. The hospital is situated near Ballyloughane which is one of Galway’s most exciting beaches for observing seashore life. Also good for observation, with its powerful high frequency X-ray generator and rotating anode X-ray tube, the Ziehm Vision R combines the convenience and versatility of a mobile platform with advanced vascular imaging capabilities surprisingly similar to fixed angiography installations. Derek Lohan, Interventional Radiologist at Merlin Park Hospital,

Galway: “Following a detailed tender process which evaluated each of the major vendors, the Ziehm Vision R stood out as the ideal C-Arm unit for our busy vascular interventional service. Equipped with a wide range of vascular imaging features, this 31cm image intensifier reliably produces superior image quality even in the most challenging of clinical scenarios and with dose minimisation in mind. High-contrast LCD displays on the C-Arm and mobile monitor cart allow for appropriate positioning of both components without obstruction of Radiologist or Radiographer view. An intuitive user-interface and everavailable vendor support network provide a level of reassurance and comfort that is difficult to match.” Michael Leonard, Business Manager at Xograph Healthcare Ireland said: “Merlin Park will be kept fully informed and in control with the revolutionary Ziehm ‘VisionCentre’ on this unit. The interactive and intuitive touch-screen control,

Anne Marie Rowings, Sarah Parnell-Mooney, Dr Derek Lohan - Consultant Radiologist and Maggie O Leary from Merlin Park Hospital with Michael Leonard, Business Manager for Xograph Healthcare Ireland and Anne Marie Hannon from Merlin Park Hospital.

similar to a smartphone, allows fast adjustments in image orientation, contrast, brightness, virtual collimation and more. Not only this but the integrated Ziehm Advanced Active Cooling system (‘AAC’) makes this C-arm particularly suited to lengthy and demanding procedures in vascular and interventional surgery.”

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Image guided surgical system treats blood clots in the brain A new image-guided surgical system under development at Vanderbilt University uses steerable needles to penetrate the brain with minimal damage and suction away blood clots. For the last four years, the team at Vanderbilt has been developing a steerable needle system for transnasal surgery: operations to remove tumours in the pituitary gland and at the skull base that traditionally involve cutting large openings in a patient’s skull and/or face. Studies have shown that using an endoscope to go through the nasal cavity is less traumatic, but the procedure is so difficult that only a handful of surgeons have mastered it. The system is described in an article accepted for publication in the journal IEEE Transactions on Biomedical Engineering. It is the product of an ongoing collaboration between a team of engineers and physicians headed by Assistant Professor Robert J. Webster and Assistant Professor of Neurological Surgery Kyle Weaver. Professor Webster’s design, which he calls an active cannula, consists of a series of thin, nested tubes. Each tube has a different intrinsic curvature. By precisely rotating, extending and retracting these tubes, an operator can steer the tip in different directions, allowing it to follow a curving path through the body. The system for treating brain-clots only needs two tubes: a straight outer tube and a curved inner tube. Both are less than one twentieth of an inch in diameter. When a CT scan has determined the location of the blood clot, the surgeon determines the best point on the skull and the proper insertion angle for the probe. The angle is dialled into a fixture, called a trajectory stem, which is attached to the skull immediately above a small hole that has been drilled to enable the needle to pass into the patient’s brain.

Use the Power of: Available in Print Locally and Worldwide via the Internet 8


Test of steerable needle system on a phantom brain clot made from gelatin.

The surgeon positions the robot so it can insert the straight outer tube through the trajectory stem and into the brain. He also selects the small inner tube with the curvature that best matches the size and shape of the clot, attaches a suction pump to its external end and places it in the outer tube. Guided by the CT scan, the robot inserts the outer tube into the brain until it reaches the outer surface of the clot. Then it extends the curved, inner tube into the clot’s interior. The pump is turned on and the tube begins acting like a tiny vacuum cleaner, sucking out the material. The robot moves the tip around the interior of the clot, controlling its motion by rotating, extending and retracting the tubes. According to the feasibility studies the researchers have performed, the robot can remove up to 92% of simulated blood clots. “The trickiest part of the operation comes after you have removed a substantial amount of the clot. External pressure can cause the edges of the clot to partially collapse making it difficult to keep track of the clot’s boundaries,” said Webster. The goal of a future project is to add ultrasound imaging combined with a computer model of how brain tissue deforms to ensure that all of the desired clot material can be removed safely and effectively. Source: MTB europe




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Oak Medical Services Ltd Unit 5A, Albert Street, Brigg, North Lincolnshire DN20 8HQ

New portable decon system for Infection Control The inside of all new Hughes Tank Showers are now routinely treated in the factory with the SST to minimise the risk of Legionella occurring once the tank is filled with water on site.

Hughes has launched a powerful new portable decontamination system for Infection Control and the fast and effective treatment of CBRN hazards. The compact back-pack comprises a Hughes ultrasonic atomizer spray and a specially formulated chemistry stored in a pressurised delivery system. The company already offers a range of decontamination systems, and this latest addition is the result of collaboration with several partners specialising in biological and chemical treatments for infection control and CBRN substances. They have been optimized for use with the Hughes atomizer for a wide range of hazards. Two formulations are available, one for Infection Control and a double strength for CBRN applications. Together with the Hughes Atomizer they offer a single versatile system for dealing with threats from the hospital ward to the battlefield – in fact, wherever there is a risk of contamination or infection. A rechargeable compressed air cylinder within the back-pack provides the propellant to carry the chemical to the Atomizer nozzle for delivery as a fine spray on to the surface being treated. The spread and size of the spray can be adjusted according to the application. Atomizing the spray ensures effective coverage without the risk of excessive wetting. In addition to spraying directly on to contaminated surfaces, the Atomizer can be used to create a mist to capture airborne viruses. The MDF 500 formulation has been specifically developed by US specialist MODEC Inc., an established supplier of decontamination products. Hughes has worked closely with the European distributor, Health Pure Tech of France, to bring together the specially formulated chemical and atomizer delivery into a convenient portable system. The chemistry has completed EEC testing and is suitable for treating a wide range of hazards

New back pack in use with the Hughes Atomizer delivery system such as the Norovirus, Anthrax and Avian flu. It can also be used to treat mould or the potentially toxic residue from flood damage. MDF 500 comprises a 2-part chemistry which is premixed and stored within the back-pack, remaining active for up to 8 hours. The system uses chemical and biological processes to encapsulate and safely supress contamination which may be deposited on surfaces or airborne. This process of containment reduces the risk of further dispersion and makes it easier to collect for safe disposal.

As part of this integrated solution, particularly for hospital use, the complete system can be conveniently supplied within a standard hospital trolley, ensuring complete mobility and compatibility with existing cleaning and hygiene regimes. Where trolley access is limited, backpack versions remain the best option, enabling operators to take the treatment wherever it is required. For larger equipment such as trolleys and operating tables, a fully fitted demountable trailer is available. A series of fixed and hand-held ultrasonic spray guns deliver the various stages of the treatment as equipment passes through the trailer from dirty side to clean.

MDF 200 is a double strength formulation specifically intended for use in CBRN applications. The chemical and delivery system employed in the new back-pack can also be used as part of the Hughes Self Sanitising Technology (SST) EndoStat™. This is a multi-stage anti-microbial treatment for cleaning, disinfection and protection. It is ideal for use in hospitals and wherever there is a risk of contamination. Surfaces are first cleaned and decontaminated using the back-pack chemistry and then the Hughes SST is used to spray on a protective coating to prevent future contamination.

Fully fitted demountable trailer for decontamination of larger equipment. For further information telephone: +44 (0)161 430 6618 or visit our Website: When responding to articles please quote ‘OTJ’

Unique Swedish registry study may change treatment for heart attacks Aspiration of blood clots from the coronary artery of the heart in cases of acute myocardial infarction does not save more lives than simple treatment with balloon expansion. This is the finding of a unique new Scandinavian study being presented today at the European Cardiology Conference in Amsterdam. The findings are also being published in the New England Journal of Medicine. - Our results call into question the benefit of suctioning off blood clots as a routine. The findings of the study will probably have an immediate effect on clinical practice and international guidelines, says lead author Ole Fröbert, a professor at the Department of Cardiology, Örebro University Hospital. The study was coordinated by Uppsala Clinical Research Center (UCR), which is an entity within Uppsala University and Uppsala County Council. The study comprises 7200 patients and is the first study of aspiration of blood clots in acute myocardial infarction that is large enough to draw meaningful conclusions about mortality and morbidity. It is also the largest randomised study of a treatment technique for acute myocardial infarction ever undertaken. The study is unique, and Sweden’s well-organised medical care system with national quality registries has been a precondition for its implementation. - Thanks to our public registries the study was with highest imaginable quality at a marginal cost compared with a conventional clinical research study. This type of study opens up the possibility of evaluating established forms of treatment that are important to patients but lack commercial interest and can help Sweden regain its role as world leader in clinical investigations, says Stefan James, director and initiator of the study and a specialist consultant physician and associate professor at UCR. The study was carried out in collaboration with all hospitals in Sweden. Half of the patients received only balloon (stent) treatment and the other half underwent aspiration treatment, to suction off a blood clot prior to balloon treatment. The results show that mortality 30 days after the operation did not differ between the groups. Nor was there any difference between the two groups regarding for example the risk of a new heart attack, stroke, or complications stemming from treatment. Nor did high-risk groups such as smokers, patients with diabetes, or patients with large blood clots evince any benefits from the treatment. International guidelines currently recommend that patients with acute myocardial infarction should be treated with removal of blood clots by aspiration, and it has been regarded as especially effective in patients with large blood clots. However, later research has shown that suctioning off a blood clot can entail risks of stroke or blood clots, for example. - Our results show that suctioning blood clots is free of risk, but that patients don’t benefit from it, says Stefan James. For more information, please contact Stefan James, associate professor of cardiology, Uppsala Clinical Research Center (UCR), mobile: +46 (0)705-94 44 04, e-mail: or Ole Fröbert, professor of cardiology at Örebro University Hospital, mobile: +46(0)730-89 54 13, Reference: Fröbert, Lagerqvist et al, Thrombus Aspiration during ST- Elevation Myocardial Infarction - A Multicenter, Prospective, Registry-Based Randomized Clinical Trial, New England Journal of Medicine



GE Healthcare

Rediscover space and movement Discovery IGS 730

The Discovery* IGS 730 angiography system brings both extremely highquality imaging and complete workspace freedom to the hybrid operating room. Its unique mobile platform brings all the power of a fixed imaging system to the table, yet it can be moved aside, so multi-disciplinary teams can complete procedures comfortably, with unobstructed access to patients. High-end fluoroscopy image guidance, advanced applications, 3D image fusion – it all comes on a sophisticated gantry that travels on predefined paths with laser-guided precision. Now one room accommodates a wide range of endovascular, cardiac, hybrid and open surgical procedures, free of interference from fixed floor or ceiling system structures. * Trademark of General Electric Company

For further information please contact David Britton at GE Healthcare. e-mail : Tel 07831697463

Operating Room Broadcast Limited Biodegradable surgical sutures

could treat brain infections A plastic material already used in absorbable surgical sutures and other medical devices shows promise for continuous administration of antibiotics to patients with brain infections, scientists are reporting in a new study. Use of the material, placed directly on the brain’s surface, could reduce the need for weeks of costly hospital stays now required for such treatment, they say in the journal ACS Chemical Neuroscience. Shih-Jung Liu and colleagues explain that infections are life-threatening complications that occur in about 5-10 percent of patients who have brain surgery. Current treatment involves intravenous antibiotics for up to eight weeks and extended, costly hospital stays. • MDT meeting rooms full patient data on display at the same time with up to 32 image sets linked, HD video conferencing and remote viewing via our VIRTUAL MDT portal • Theatres monitor theatres in real-time, team discussion pre op/post op MDT LIVE for teaching with two communication to theatres • A & E - real time triage with live broadcast of vitals, video conferencing for stroke treatment, cardiac and serious multi medical injurys • Telemedicine monitor hundreds of patients vitals remotely and two way video and audio communication • Wards monitor patient movement, care, records and drugs via secure password entry whiteboard replacement programmes

Previous studies showed that drug-delivering plastics could release antibiotics directly into the brain. However, additional surgery was needed to remove the plastic when treatment finished. Liu’s team sought to develop a biodegradable version using a dissolvable plastic called PLGA. They describe development of PLGA fibers that release vancomycin, a powerful antibiotic that kills many microbes, including the infamous “MRSA,” which shrugs off most other known antibiotics. They tested the fibers in rats, which are stand-ins for humans in these types of studies. The fibers successfully released vancomycin for more than eight weeks in the brain and did so without apparent side effects. Source: American Chemical Society

• Teaching links seamlessly on a global platform driven from the MDR video wall and share all or some of the information •Robots Link and control robots globally, infection control, patient rounds, battle field, prisons and other remote locations

“The South and West Wales ODP Professional Network” Advanced Notice of Forthcoming Meetings: 30th September 2013 and 16th December 2013

Operating Room Broadcast Limited Sales 24/7 Tel: 01223 902 069 Support 24/7 Tel: 0800 211 8683

Meetings commence at 9.30 am Prince Charles Hospital MDTU classroom 4, 1st floor. If anyone would like further information about any of the meetings or wish to discuss anything as part of the agenda, please contact: Lee Fyfe - When responding to articles please quote ‘OTJ’

Find out more 02921 680068 • e-mail

Deborah Ryan - Issue 276

September 2013


Theatre nurses design ‘dignity bra’ Fiona Cartwright and Natalie Reid, Registered Nurses working within the theatre environment, observed that female patients’ breasts often become exposed in preparation for surgery. They conducted an initial audit of 40 women, which was then extended to 100 women, to gauge patients’ opinions. Of the 100 women questioned, 95% of them were unaware that they may become exposed in preparation for surgery and 99% stated that they would like to wear a dignity bra if it was offered to them.

Long-Term Variations In Blood Pressure Raises Risk Of Early Death Anyone who has had frequent blood pressure checks knows that blood pressure is never constant. We’ve all had stressful days and we generally attribute high swings in blood pressure to this. Needless to say we are reassured if a subsequent blood pressure check a few days or weeks later shows a lower reading. Now scientists have found that variations in blood pressure over long periods, of months and years, raises the risk of ill-health and is a predictor of early mortality in hypertensive patients. Researchers at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow calculated the variability of blood pressure, over long periods of time - one, four, five and nine years, in 14,522 hypertensive patients attending the Glasgow blood pressure clinic. Their results showed that the magnitude of visit-to-visit blood pressure variation was a strong predictor of mortality, independent of their long-term average blood pressure. Even those individuals who would be considered well-controlled in terms of blood pressure values at each visit, showed a higher risk if they had wide swings in their blood pressure readings between clinic visits. The findings have been published in the journal Hypertension with an accompanying editorial which stated: “The demonstration that ultra long-term BPV recorded over up to 9 years is also a strong predictor of mortality in treated hypertensives further emphasizes the importance of not only achieving but also maintaining stable BP control in the long term.” High blood pressure is considered a silent killer, as it causes no symptoms and if untreated results in early stroke, heart attack and death. The current treatment of high blood pressure revolves around regular blood pressure checks and adjusting treatment to get the blood pressure down to safe levels.

Fiona and Natalie designed and created the ‘Digni’ Bra to protect patients while they are at their most vulnerable. They designed a bra that met MHRA regulatory standards, was cost effective, hygienic (disposable, single use), easily removable (paper that can be cut/torn if access to the chest is deemed necessary), minimalistic (strapless so as not to interfere with surgery of the shoulder/ neck area along with essential cardiac monitoring) and non-transparent (a deep royal blue colour was selected of grade 35gsm paper thickness to protect patient modesty). The Digni Pants are unisex to protect the male patients also. Following an initial trial at the Vale Hospital (Part of the Nuffield Group) the feedback from patients and consultants was overwhelmingly positive. The Digni sets have been taken on by Nuffield as a group and are on trial in NHS hospitals nationwide along with other private hospital groups. See the website at: and Facebook page: Digni Products Limited. When responding to articles please quote ‘OTJ’

“HELP” Are you changing your address soon? Is your company relocating? Is your operating theatre or department moving sites, relocating or closing? No longer require your copy of the OTJ? Returned journals are a waste of resources! Please help us to help you by keeping us up to date with your current address. This can be e-mailed or faxed to: Fax: 07092 097696 or you can just telephone us during office hours on: 02921 680068

Dr Sandosh Padmanabhan, who led the study, said: “Blood pressure is inherently variable and will fluctuate due to a complex interaction of various factors. “Factors such as stress, seasonal effects and people not taking medication regularly can cause increased blood pressure fluctuations. “The research has implications for how we best manage hypertension in patients. For example, physicians will need to give more consideration to blood pressure variability when monitoring and treating high blood pressure. The results of our study also highlight the importance of not only taking blood pressure medicines to reduce blood pressure but also taking them regularly. Further studies could help identify specific drugs that could reduce variability.”

UK healthcare system grapples with cost of replacing outdated medical equipment • Close to £300 million is required to replace out-of-date diagnostic imaging equipment between 2013 and 2015 in the UK • Imperative need for healthcare providers to develop cost-effective replace-ment strategies Due to legislative reform, demographic change and rising prosperity, demand for healthcare services is rising across the world, fueling the requirement for up-to-date medical equipment that plays an indispensable role in the provision of high quality healthcare. This is, however, exerting considerable financial strain on the European healthcare systems where a proportion of medical equipment is currently out-of-date and needs to be urgently replaced. According to latest research from Siemens Financial Services (SFS), UK healthcare organisations will have to invest around £294 million between 2013 and 2015 to replace out-of-date diagnostic imaging equipment (defined as equipment over 10 years old) alone. The capital expenditure required for these essential replacements is even higher for Spain and France, totaling £368 million and £373 million respectively. As public finance continues to be stretched by austerity measures and efficiency policies, healthcare organisations need to find ways of accessing efficient and avail-able finance to fund urgent medical equipment upgrades and renewals. SFS previous research has shown that asset finance, for instance, is growing as a financing technique for the acquisition of medical equipment across the world. David Martin, General Manager for SFS in the UK, comments, “Up-to-date medical equipment plays a crucial role in the provision of quality healthcare services and improvement of health outcomes. In particular, diagnostic imaging technologies fa-cilitate accurate, early diagnosis and reduce invasive procedures, making a vital contribution to efficient and effective healthcare provision. It is therefore imperative that healthcare providers urgently replace the backlog of outdated medical imaging equipment. At a time of acute budgetary pressure, equipment replacement can often be made affordable through the use of asset finance techniques such as leasing and renting. “Asset finance allows healthcare organisations to spread the cost of equipment over its useful lifetime. Such financing arrangements often cover not only the equipment acquisition cost, but also maintenance, service and sometimes consumables. Their growing popularity with healthcare providers around the world indicates the useful-ness of being able to align payments with benefits gained.” Methodology: Based on a range of proprietary and third-party data on future medical device market projections as well as official studies into the age of the diagnostic imaging equipment, a conservative estimate model was built to calculate the cost of replacing diagnostic equipment over ten years old between 2013 and 2015. The report studies the financial scale of essential medical equipment acquisition in ten global healthcare markets. For more information, visit:



Alma Medical



The Oxford Rhizolysis Pillow

The Oxford Ankle Block Support

We can replace any operating table mattress or any hard to find items To order please call: 01869 351855 Email:

Monklands purchase multiple dental units from Xograph Monklands Hospital has just celebrated the 65th anniversary of the NHS by presenting a certificate to all the newborn babies who share the same birthday. Another less conventional delivery this year came from independent medical equipment supplier Xograph Healthcare in the form of new dental X-ray equipment for the Monklands Hospital Emergency Department including a digital panoramic and cephalostat system with digital intra oral system. The fundamental principles of the NHS have survived, unchanged, for 65 years but needless to say technology changes to dental imaging have never stood still. The latest digital systems such as the Planmeca ProMax Scara 2 as supplied to Monklands Hospital incorporate a digital Panoramic (Pan) system with integral digital cephalostat (Ceph), which scan the patient’s head horizontally with a narrow X-ray beam. Importantly, the ProMax ensures a lower effective patient dose when comparing with more traditional film-based Panoramic and Cephalometry techniques. Similarly the Planmeca X-ray dental generator, the ProX, makes intraoral imaging much easier for the user and by far more comfortable for their patients, delivering superior image quality X-rays for almost instant review.

Competition Commission: Private patients pay too much Most patients in UK private hospitals are paying more than they should for treatment because of a lack of local competition, an inquiry has found. More than 100 private hospitals around the country are in areas with little rival healthcare provision, says the Competition Commission (CC). Many of these hospitals are owned by three major groups, the CC said. It said the buying power of health insurance firms did not offset the hospitals’ strong position. About 80% of private patients fund their treatment through medical insurance, which is often paid for by their employers. Although prices charged by operators to insurers are set nationally, the commission said it believed that the lack of local choice pushed up premiums for all patients, because insurers had no option but to use the local hospital. “The lack of competition in the healthcare market at a local level means that most private patients are paying more than they should, either for private medical insurance or for self-funded treatment,” said the commission’s chairman, Roger Witcomb. “The lack of available and comparable information, often less than is available to NHS patients, also makes informed choices - which could help drive competition - for these patients difficult.” ‘Market power’ Hospital groups BMI, Spire and HCA had been “earning returns substantially and persistently in excess of the cost of capital”, the commission said. The two biggest health insurance firms, Bupa and AXA PPP, had achieved “significantly lower prices than the smaller insurers” and had “some countervailing buyer power, Bupa more than AXA PPP”.

“However, no insurer has countervailing buyer power that can fully offset the market power of BMI, Spire and HCA,” the commission’s provisional findings said. The commission recommended moves to make more information available about the quality of hospitals’ services and the level of fees charged by consultants. It also suggested that operators owning a cluster of hospitals in one area should have to sell off some of them. Responding to the commission, BMI said its findings were “based on fl awed analyses of the reality of providing high quality private healthcare”. “We reject absolutely any assertion that BMI Healthcare and its hospitals exercise market power or that we make excess profits at the expense of patients. “The vast majority of BMI’s 69 facilities, in a UK market with over 500 rival facilities, face very significant local competition from other private hospitals and, increasingly, from the NHS.” Spire chief executive Rob Roger said the findings were “based on an unrealistic assessment of the markets in which we operate”, while HCA said it was “disappointed that quality of clinical care and investment in innovation seems to have been ignored by the Competition Commission”. For its part, Bupa welcomed the findings as “good news for patients”. Managing director Damien Marmion said: “Millions of people with health insurance rightly expect high-quality healthcare for an affordable price. “By tackling the lack of competition that has damaged the sector for too long, the commission has understood the need for strong action and has put patients first.” Source: BBC

UKs fastest-growing bone bank celebrates summer of awards success Alison Cottrell, Clinical Applications Manager at Xograph Healthcare with Lesley Sharp, Superintendent Radiographer, Aileen Anderson and Janice Miller, Senior Radiographers from Monklands Hospital and Charlie Doherty, Country Manager at Xograph Healthcare and Lesley Henderson, Senior Radiographer from Monklands Hospital. Lesley Sharp, Superintendent Radiographer at Monklands Hospital said: “These units provide Monklands Hospital Emergency Department, Facial Maxilliary and Dental Services with excellent diagnostic images. The user friendliness of the system has greatly impressed radiographers. Xograph were very helpful throughout the process and I would definitely use them again in the future.’’ Charlie Doherty, Country Manager at Xograph Healthcare said: “Monklands will benefit from a wide range of intra and extraoral X-ray imaging techniques, meeting the needs of modern surgical dentistry including the automatic aligning ProMax from ‘Pan’ to ‘Ceph’ and greater flexibility with the adaption of short cone (20cm) and long cone (30cm) imaging techniques on the ProX.” When responding to articles please quote ‘OTJ’


Hospital Innovations, a Cardiff-based supplier of human tissue for transplant, is celebrating after being shortlisted for and winning numerous esteemed awards this summer. Sarah Lister-Sims, Hospital Innovations Corporate Compliance Director, was recently crowned the best Small Business Director in Wales at the Institute of Directors Awards in Cardiff. Sarah has subsequently been shortlisted for the Director of the Year 2013 Awards national final in London on 11 October, where she will be competing against Aimee Bateman of and Rachael Wheatley of Waters Creative.

Hospital Innovations was delighted to attend the Business in the Community Wales Gala Dinner as a nominee for the Responsible Small Business of the Year Award. The UKs fastest-growing bone bank was shortlisted in recognition of its positive environmental stance, evident in work such as its tissue return scheme which has saved hospitals over £1 million by reducing wastage. Hospital Innovations was also commended by the BITC for its work with learning disability charity Touch Trust and the Managing Directors on-going support of Cardiff Metropolitan Universitys Business and Sports Science schools.

Hospital Innovations was named International Sports Medicine Distributor of the Year and International Distributor of the Year at the prestigious annual awards ceremony of Chicago-based tissue supplier RTI Biologics in June.

Hospital Innovations was one of three businesses in the running for a Corporate Social Responsibility accolade at the IWA Inspire Wales Awards on 18 June, also acknowledging its community work supporting Touch Trust and Cardiff Met.

The company was commended for the range of sports allograft that they offer and the high calibre of the distribution services they provide, and for achieving the highest overall usage of RTIs products worldwide.

MD Phil Davies commented: Even being nominated for such important awards is an honour, and really affirms my belief that we are at the forefront of the sports medicine field.

Phil Davies, Managing Director of Hospital Innovations, said: Sarah is a real asset to the Hospital Innovations team and its fantastic that her talent and hard work is being formally acknowledged by business experts at the IoD.

We are extremely proud of our work, and for our achievements to be celebrated at such prestigious events is brilliant.

To win not one but two RTI Awards was a total, but very welcome, shock and we are thrilled to have been recognised by a company that we hold in high regard. THE OPERATING THEATRE JOURNAL

It is hoped that the companys awards successes will continue throughout the year, as Hospital Innovations await news of their application to the Made in Wales Awards on 23 October.

Feel right at Homerton Join our family unit Here at Homerton Hospital NHS Foundation Trust, we take great pride in the friendly, supportive working environment we’ve created. An environment built with open and honest relationships, where staff are encouraged to realise their full potential. Thanks to an exciting number of opportunities that have become available within our extremely well organised, state of the art theatres, our family of experienced Theatre Nurses, ODP’s and Theatre Practitioners is about to grow. Specialist care includes obstetrics, neonatology, fetal medicine, fertility, neuro-rehabilitation and bariatric surgery across east London and beyond.

Not only would you become an integral part of our team, everything is in place to reward great work and develop your professional skill sets along the way. Some of the positions available are: ODP/Anaesthetic Nurse Staff Nurse/Practitioner Recovery Theatre Scrub Nurse/Practitioner To put yourself in the frame, you can find out about each of our vacancies and apply online at

Virtual Reality Headset Could Enable Immersive Remote Surgery A novel headset that completely immerses gamers in a virtual reality has the potential to bring some real-world advances to medical technology. Plextek Consulting (Cambridge, UK) is using the Oculus Rift headset to apply what it calls immersive telepresence to remote examinations and diagnostics. The video communications system (pictured) that simulates complete user immersion within a remote location could be used, for example, to monitor clinical procedures, check on wards and patients and, by leveraging robotics, make it easier and more cost-effective to use medical equipment and perform surgery remotely, notes the company. Simply using a forward-facing camera on the Oculus Rift makes it difficult to achieve a fully-immersive virtual reality effect whilst maintaining low latency, the lag time that can measure just tens of milliseconds yet create discomfort and nausea for the user. Plextek Consulting has found a way to heighten the user experience while minimising latency by using a steerable remote camera to track the user’s head. High-definition video and tracking control are transmitted wirelessly between the Oculus Rift and remote head. By mimicking the user’s head position, the remote camera helps to produce a realistic and immersive visual scene, explains the company in a press release. Given its expertise in image processing and wireless technology, Plextek Consulting is well positioned to “drive innovation in immersive telepresence technologies and design cost-effective solutions that bring virtual reality technology to the real world,” says Graham Tootell, Senior Technology Consultant.

Source: medtechinsider

JOIN THE FACULTY AND HELP DEVELOP OUTSTANDING NHS LEADERS The NHS Leadership Academy is seeking to expand its team of leadership experts by tendering for 35 practitioners to support the delivery of its range of leadership development programmes. Working with specialists in organisational and leadership development, the Academy is able to draw from a wide range of skills, expertise and experience in the health and public sector and beyond, to respond and adapt to the changing needs of the NHS. Known as the Academys faculty, these specialists are involved in the design and delivery of a number of its high-profile national programmes including NHS Top Leaders, the NHS Graduate Management Trainee Scheme, nursing and midwifery leadership development programmes and the recently launched professional development programmes. The faculty includes individual practitioners as well as named individuals from large consultancy firms and academic organisations. Dr Dave Ashton, head of practice at the NHS Leadership Academy, said: To achieve the Leadership Academys principal aim of developing outstanding leadership in health and to realise the benefits this will give for patient experience and outcomes, its vital we have the right resources in place. Our faculty are a team of highly expert practitioners in the leadership and organisational development field who support us in achieving this aim. The variety of work for members of the faculty is huge, ranging from relatively small group interventions with senior NHS leaders, through to large workshops of over 100 people. A number of the Academys faculty work closely together for the input in to the design of some of our key programmes and the delivery of many. Recruitment for the faculty is through OJEU tender. Successful bidders will be contracted from January 2014 for an initial three years with the opportunity to extend for a further year.

More information on the tender and the work of the Academys faculty is available on the NHS Leadership Academy website www.leadershipacademy. or the Official Journal of the European Union (OJEU).

Find out more 02921 680068 • e-mail

Issue 276

September 2013


www.Operati peratingTheatre ng 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

LONDON SENIOR THEATRE PRACTITIONER This is an exciting opportunity for a confident & competent Theatre Practitioner. You will need to be multi skilled with good leadership experience to join this highly professional day case team. A dynamic & enthusiastic RGN or ODPs who has comprehensive scrub skills as well as anaesthetic skills are ideal. It is essential that you are a good team player & have the commitment to the continued delivery of first class patient care as well as the professional development of the team. Further qualifications which support your development will be expected. We also require a Healthcare Assistant to join this team. Current Theatre experience is necessary.

THEATRE RNs & ODPs make a lifestyle choice – choose New Zealand

Tel: 01303 840 882 Fax: 01303 840 969

Theatre RNs and Operating Department Practitioners are highly prized in New Zealand so the choice is yours. A large teaching hospital, a smaller base hospital, a weekdays-only job in one of NZ’s smart private clinics – whatever your choice we’ll find the right job for you.

WEST MIDLANDS THEATRE PRACTITIONERS You will be an enthusiastic & flexible RGN or ODP who wants to develop & build on their existing skills in a dynamic perioperative environment. Multi-skilled applicants are ideal however Anaesthetic Practitioners &/or Scrub Practitioners are invited to apply. Scrub skills in Orthopaedics are desirable however scrub skills in other specialities are also welcome. Excellent communicators are essential & patient focused team players are needed.

If you are a western or Australasian-trained Theatre Nurse or ODP with two years post-qualification experience contact us now for more information. Send us your CV or call us on:

+44 207 959 1105 (marking your email NZ)

Tel: 01303 840 882 Fax: 01303 840 969

Beehive Solutions awarded UK Distributorship for Fotona Gynaecology lasers Fotona are delighted to announce that Beehive Solutions Ltd will be their UK Distributor for Lasers used in Gynaecology, with immediate effect. ‘Fotona’ have been manufacturing premium quality lasers since 1964, and are widely recognised as one of the leading players in Aesthetic and Surgical laser production and research. The Gynaecology sector represents a new and exciting field for lasers use, and ‘Fotona’ are leading the way in developing dedicated laser systems and techniques to bring effective laser treatment to the public. Mr Vlaho Krisper, Business Development Manager at Fotona says “We have been working with ‘Beehive Solutions’ for a number of years in support of UK sales of our other laser systems, and have been impressed with their dedication and customer service. We know that this award will be of benefit to ‘Fotona’ and the UK Gynaecology market”. ‘Beehive Solutions’ are a UK distributor for a wide range of healthcare related products, including medical lasers, disposable instruments, clinic consumables and compression garments. Mr Craig Smith, Director at ‘Beehive Solutions’ comments “We are proud of the confidence ‘Fotona’ have shown in us as a result of our previous business with them, and look forward to bringing real benefits to the Gynaecology field with the adoption of new laser techniques, to effectively treat some of the most frequent womens’ health complaints” More information can be found on the Beehive-Solutions website or contact the team on or 020 8550 9108

View our latest vacancies at

Given the choice, wouldn’t you want to work here? We all have choices to make in life. For our clients, those choices can be among the most emotionally complex they’ve ever faced. For you, it’s a question of where next in your career. We are the British Pregnancy Advisory Service (bpas), a national charity working on behalf of the NHS to provide abortion and sexual healthcare services across the UK. If you are a Registered Nurse or an ODP, we would like to hear from you in relation to either of the following roles:

Perioperative Practitioners £22,564 – £27,251 pa, (plus £4,542 for Richmond and Streatham), pro rata Based Brighton, South Birmingham, Leamington Spa, Winchester, Richmond or Streatham

Operating Department Practitioners or Anaesthetic Nurses £25,192 – £30,350 pa, (plus £4,542 for Streatham), pro rata Based Streatham, Leamington Spa or Winchester Whichever role and unit you choose, you will be working with a friendly Operating Department team within a day surgery setting, and working across anaesthetics, the operating room and recovery areas. No experience is necessary (aside from an anaesthetics qualification for the ODP/Anaesthetic Nurse role) as full training will be given. Full details of all available roles can be found on our website or by emailing If you would prefer to speak to somebody about our opportunities, please contact us on 01789 265026.

Check out the latest Study Days and Seminars at :

All applicants must be pro-choice.

Registered Charity Number 289145.

Find out more 02921 680068 • e-mail


follow @bpasjobs on Twitter

Issue 276

September 2013


AfPP Celebrates Summer Residential Success AfPP was delighted when their new Summer Residential proved such a hit with members. The weekend took place in York from 2-4 August and over 200 delegates attended along with Medical Device Companies who supported the weekend.

BIG RISE IN THE POPULARITY OF FAT TRANSFER AND REMOVAL TREATMENTS There has been a massive increase in the popularity of fat transfer procedures, such as breast and buttock augmentations, with enquiries for fat transfer surgery up 188% in the past 12 months, according to new figures from private healthcare search engine looked at the most popular surgical and non-surgical cosmetic treatments over the past 12 months, and there has been a bigger increase in enquiries for fat transfer procedures than any other treatment. Fat transfer procedures, such as breast augmentation using recycled fat from one part of the body, such as your belly, legs or bum, and injecting it into the breasts, is proving particularly popular with women because it eliminates the need for implants, and offers a natural looking enlargement. Fat removal treatments are also in demand. According to the OECD (Organisation for Economic Co-opearation and Development)(1), obesity rates in the UK are the highest in Europe. And figures reveal a significant rise in people enquiring about fat removing surgery - with liposuction and tummy tuck treatments up 75% and 74% respectively.

The event provided topical education over 2 days, as well as plenty of networking and socialising opportunities culminating in a Gala Dinner on the Saturday night and the exciting buzz from the event was palpable.

The following table shows the most popular surgical and non-surgical cosmetic treatments over the past 12 months, in terms of increase in the number of booking enquiries compared to the previous year.

Treatment %Increaseinenquiries Surgical/Nonsurgical FatTransfer 188% Surgical SemiͲPermanentMakeUp 159% NonͲsurgical Labiaplasty 109% Surgical BreastImplants 107% Surgical LaserHairRemoval 89% NonͲsurgical TattooRemoval 87% NonͲsurgical Botox 78% NonͲsurgical Liposuction 75% Surgical TummyTuck 74% Surgical DermalFillers 66% NonͲsurgical

Comments heard over the weekend from our delegates include:

Caelen King, CEO of, comments:

“The speakers were inspiring and have given me some real learning to take back to my colleagues”

Demand for both surgical and non-surgical aesthetic procedures shows no sign of slowing down. For example, fat transfer procedures have grown in popularity with patients attracted to the idea of a more natural alternative to the traditional silicone breast and buttock implants.

“Don’t change anything it was excellent” Dawn Stott, CEO, AfPP commented: “The decision to hold our extended study day at York proved to be an excellent one. It was obvious that everyone who attended used the opportunity to network and share best practice; our medical device partners socialised alongside us and it gave everyone the opportunity to relax together. With the lack of funding and education available within the healthcare sector we continue to develop new ways of working to provide accessibility to good quality education at affordable prices. Because of the success of this year’s event we plan to hold a similar event in 2014, which will form part of our 50th anniversary celebrations.” If you would like more information on our study day programme or to discuss a bespoke package of learning for your theatre team please contact Pauline Thompson, AfPP events team, on 01423 881300.


S 18

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From breast enlargements and dermal fillers to laser hair removal and botox, Britons are clealy becoming more comfortable taking control of every aspect of their appearance. They are happy to invest in themselves and change things about themselves that they dont like. If you are looking to have some cosmetic surgery carried out, it is important to do your research before committing to check clinic reviews and compare prices. There are thousands of reputable private clinics across the country to choose from, and spending some time researching the market could save you hundreds if not thousands of pounds. 1/ According to the Organisation for Economic Co-operation and Development, the UK has the highest obesity rate in Europe.

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“The educational content was brilliant”

National Conference

M&K Update Ltd © 2013 | |

Delivering safe and effective practice in

The Operating Theatre Safe and effective practice is the responsibility of all theatre professionals and is constantly in the spotlight particularly in the prevailing economic climate. Clinicians and managers are under constant pressure to find and devise effective and efficient solutions to ensure safe but cost-effective care. This event addresses these issues and promotes networking, building professional relationships and exchanging of ideas through face to face contact with theatre professionals from all over the UK. The venue is Manchester Conference Centre which is located near the vibrant shopping centre of Manchester, with excellent road, rail and air links. There is accommodation available at the venue itself and details can be found on the M&K web site. PROGRAMME INCLUDES

™ BZcidgh]^e[dXjhVcYhigViZ\^Zhi]ViXVcZchjgZkVa^Y^in of practice assessment ™ :  VganLVgc^c\HnhiZb:LH/I]Zg^\]iidda[dgi]Z_dW4 ™ I]ZVigZHV[Zin·idi]ZX]ZX`a^hiVcYWZndcY### ™ >cVYkZgiZcieZg^deZgVi^kZ]nedi]Zgb^V·\Zii^c\idi]Z “core” of the issue ™ Cdc"e]nh^X^Vc6cVZhi]Zh^V·>beaZbZci^c\VJ@ system from inception to reliance

™ 9Za^kZg^c\VhV[ZVcYZ[[ZXi^kZeZg^deZgVi^kZldg`[dgXZ bdYZa/cdlVcYi]Z[jijgZ ™ >YZci^ÃXVi^dcVcYbVcV\ZbZcid[bZY^XVaYZk^XZg^h`^c the perioperative setting ™ 8a^c^XVahiV[[>ckdakZbZci^ci]ZDeZgVi^c\GddbDG reconstruction. Two sides of the same coin


CZildg`^c\|>ciZgVXi^dc| Building relationships |:mX]Vc\^c\^YZVh|;VXZid[VXZXdciVXi HOW TO BOOK

Online: Email/ Tel/ 01768 773030

12TH NOVEMBER 2013 Manchester Conference Centre, Manchester


Per person


M&K Update Ltd © 2013 T: 01768 773030 Email:

Your ďŹ rst choice in anaesthesia and airway management

Quality, innovation and choice @intersurgical


The Operating Theatre Journal  

September 2013 Edition 276