Times Past – Future Views

During my trip to UK, I visited the Old Operating Theatre of St Thomas’ Hospital which is tucked away on the top floor of an English Baroque church near London Bridge (Southwark, London) and adjacent to the famous teaching hospital Guy’s (St Thomas’ Hospital having moved to a new location in Westminster). I had seen photos of this operating theatre and although I was brought up in London, had never had the opportunity of seeing it first hand.OR at St Thomas' Hospital

The operating theatre is the oldest surviving theatre in Europe, dating back to 1822 and was used until 1860. Its location is rather odd, being on top of a church, but the wards of the old St Thomas’ Hospital were built adjacent to the church. The theatre was only rediscovered in 1956 and underwent an extensive refurbishment allowing it to be opened as a museum exhibiting a number of surgical artefacts and pharmacological potions. Whilst viewing the exhibition, it struck me that although we are nearly two hundred years down the track, many of the instruments on show looked remarkably familiar – a sigmoidoscope, Sims speculum, birthing forceps, assorted other surgical instruments. The operating theatre itself is of course drastically different, as you can see it is set up with a viewing gallery to accommodate the budding surgeons of the day, all jockeying to get the best view of the latest surgical techniques – hence the term ‘theatre’. But unlike today’s modern surroundings this theatre has a crude wooden table with a tray of sawdust underneath ready to catch the blood. Blood stained aprons hung near the door with a mirror so the surgeon could clean himself of blood spatters. The bowl was available for the surgeon to wash his hands after surgery rather than before! Anaesthesia and antisepsis were still some years away, therefore the procedures undertaken were very limited. Amputation was one of the most common procedures performed and surgeons vied for the reputation of being the quickest – often asking a member of the audience to time them. One such surgeon was Robert Liston who in the mid 1800s, it is claimed, carried out an amputation of the leg in 25 seconds! He also, so the story goes, accidently sliced off the poor patient’s testicles too!

In a hundred years time, will someone stand looking at our current operating theatres and wonder how we worked in such conditions? What will the operating theatre of 2114 look like and how will surgery be different?

Our operating theatres may cease to exist in their current configuration and may look more like high tech radiology suites. We will see more minimally invasive surgery using technologies such as those currently being trialled eg High-Intensity Focused Ultrasound (HIFU) and Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS). These technologies can be used for a variety of procedures including treatment of uterine fibroids, metastatic bone tumours, Parkinson’s disease with patients likely to be walk in/walk out same day surgery. Surgery may be undertaken by robots operated by surgeons located remotely. 3D printing is already being used in innovative ways and I am sure in the future we will see prostheses being made to measure within the operating theatre! I came across this information in an interesting blog on the ACA Research website describing the modular operating room at QEII Jubilee Hospital, Brisbane – The Operating Room of the Future OR at John Flynn Hospital

Where does this view into the future leave perioperative nurses?   Will we survive this technological revolution? We will need to reinvent ourselves using new skills and knowledge to care for patients in this brave new world. With National Perioperative Nurses Day fast approaching on 12 October, it is a perfect opportunity to consider our current and future roles. Many of us won’t be around to see the new technologies and innovations, but we can think of ways in which we can lay the foundations for the next generation of perioperative nurses to meet the challenges of the future.

What are your thoughts on the future of surgery, operating theatres and of course perioperative nurses? Get in touch and tell us what you think.

Back to Australia next week, so til then….