TOPIC 2. SURGICAL DEPARTMENT – ORGANISATION, BASIS AND EQUIPMENT
1. Organisation and functional zones
A surgical department is organised to provide assessment, preparation, operative treatment and postoperative care while minimising infection and ensuring rapid response to deterioration.
Outpatient/consultation area: history, examination, investigation planning, follow-up and minor procedures.
Inpatient ward: admission, preoperative preparation, nursing care, postoperative observation, mobilisation and discharge planning.
Operating suite: operating rooms, scrub areas, sterile storage, anaesthetic facilities, recovery area and controlled access.
Emergency/resuscitation area: rapid assessment and stabilisation of trauma or acute surgical illness.
Intensive/high-dependency care: advanced monitoring and organ support for selected critically ill postoperative patients.
Support services: imaging, laboratory, blood bank, pathology, CSSD/sterile services, pharmacy, physiotherapy and infection prevention.
2. Zoning and infection control
Movement should proceed from cleaner to more restricted areas. Doors should remain closed when possible, traffic should be limited, and sterile supplies protected from moisture, dust and unnecessary handling. Local theatre policy determines exact attire and traffic rules.
3. Operating-room equipment
Operating table: adjustable height and position; supports safe positioning and access to the operative field.
Operating lights: provide intense, shadow-reduced illumination.
Anaesthesia workstation: oxygen and medical gases, ventilation system, vaporizers where applicable, breathing circuit, suction and physiological monitoring.
Monitoring: ECG, pulse oximetry, non-invasive/invasive blood pressure, capnography, temperature and urine output when indicated.
Electrosurgical unit: cutting and coagulation using electrical energy; correct pad placement and precautions reduce burns.
Suction: removes blood and fluids to maintain visibility and airway patency.
Instrument tables and sterile drapes: maintain an organised sterile field.
Emergency equipment: defibrillator, airway equipment, emergency drugs, blood products access and resuscitation trolley.
4. Surgical instruments – basic groups
5. Patient safety and teamwork
- Use a structured surgical safety checklist: sign-in before anaesthesia, time-out before incision and sign-out before leaving theatre.
- Confirm patient identity, procedure, site/side, consent, allergies, airway/aspiration risk, anticipated blood loss and availability of equipment.
- Perform instrument, needle and swab counts according to policy.
- Document the operation, implants, specimens, complications and postoperative plan.
- Use clear communication, closed-loop confirmation for critical instructions and formal handover.
Key principle: The operating theatre is a controlled clinical environment, not simply a room containing instruments. Safety depends on zoning, sterile processing, equipment checks, communication and reliable protocols.