A modular operating theatre is a surgical room whose envelope — walls, ceiling, doors and integrated fittings — is built from prefabricated components, manufactured and checked at the plant and assembled dry on site. It is used both in new surgical suites and in the refurbishment of hospitals that stay open during the works, because it combines cleanable surfaces, an airtight room and a predictable construction programme.
What is a modular operating theatre?
In a conventional operating theatre the walls are built on site, in masonry or plasterboard, and then finished with linings, sealants and paint. In a modular operating theatre the envelope arrives on site already finished: pre-finished panels, frames, doors and technical compartments are fixed mechanically, with no wet trades.
The difference between a modular and a conventional theatre is not only in how the room is built. In a modular theatre every element is designed to work with the building services: treated air, medical gases, power, data and equipment. The walls do more than enclose the space: they house outlets, control panels, monitors, cabinets and openings for transferring materials.
Which components does a modular operating theatre integrate?
A complete modular operating theatre brings together, in a single system, elements that on a conventional site come from different suppliers.
| Component | Role in the theatre |
|---|---|
| Technical walls with pre-finished panels | Enclose the room with smooth, cleanable surfaces, house the services provisions and open for maintenance |
| Hermetic automatic sliding doors | Limit air exchange with adjoining rooms and open without hand contact |
| Technical ceiling | Houses the hermetic lighting and the laminar flow unit above the operating table |
| Theatre control panel | Brings the controls and environmental readings the team needs into one place |
| Monitors and PACS displays | Bring diagnostic images and patient data onto the wall |
| Recessed cabinets | Store materials and devices flush with the wall, with no ledges that collect dust |
| Pass-through boxes and hatches | Transfer materials between rooms with different levels of control without opening the doors |
| X-ray shielding | Protects neighbouring rooms when radiological equipment is used in the theatre |
What requirements must an operating theatre envelope meet?
An operating theatre envelope must meet five requirements, whatever the construction method.
- Hygiene. Surfaces must be continuous, non-porous and resistant to the detergents and disinfectants used in hospitals. Fewer joints and fewer ledges mean fewer places where dirt collects.
- Airtightness. A conventional operating theatre is kept at positive pressure relative to the rooms around it, so that air moves from the cleanest area towards the less clean ones. Walls, doors, joints and service penetrations must limit air leakage.
- Access for maintenance. The services behind the walls need maintenance: reaching them without demolition avoids dusty work in a controlled-contamination environment.
- Services integration. Medical gas outlets, power sockets, data points, monitors and control panels need a precise position, fixed at design stage.
- Durability. Trolleys, beds and equipment strike the walls every day: finishes must stay intact over time.
The numerical values — air change rates, pressure differentials, air cleanliness class — are set by the mechanical services design according to the standards of the country where the hospital is built. The job of the modular envelope is to make it possible to reach those values and to keep them over time.
What are the advantages over conventional construction?
A modular operating theatre offers practical advantages on site and throughout the life of the building.
- Dry construction. No plastering, filling or sanding inside the theatre: less dust, which is decisive when the hospital remains open.
- Quality checked at the plant. Components are inspected before shipping, and deviations are resolved in the factory rather than on site.
- A more predictable programme. The modules are manufactured while the building works progress, so most of the site time is assembly.
- Maintenance without demolition. Removable panels give access to the services and close again without leaving marks.
- Easy to update. When equipment or surgical specialities change, the theatre adapts by replacing or moving modules.
- One point of contact. Walls, doors, ceiling and integrated fittings belong to the same system, with fewer interfaces between different suppliers.
How is a modular operating theatre delivered, step by step?
Delivering a modular operating theatre follows six steps.
- Needs analysis. Planned surgical activity, equipment, flows of staff, patients and materials, constraints of the building and the regulations of the country.
- Detailed design. The system supplier develops the construction details with the architects and services engineers, and fixes the position of every outlet, monitor, cabinet and door.
- Manufacturing. At the plant, profiles and panels are machined, modules are assembled and services provisions and finishes are integrated.
- Inspection before shipping. The modules are checked at the factory, in a controlled environment.
- Logistics and installation. Components are delivered to site and assembled dry by specialised teams, in coordination with the services contractors.
- Testing and handover. Final checks are carried out once installation is complete. The validation tests of the theatre, meaning the air and pressure measurements, follow the procedures set by the services design and by the healthcare facility.
Can a modular operating theatre be built in a hospital that stays open?
A modular operating theatre can be built in a hospital that stays open, and this is one of the situations where a modular system brings the greatest advantage. Dry assembly reduces dust, noise and the duration of works next to active wards. Site containment measures, such as barriers and separate routes, are agreed with the hospital management before work starts. Every day saved on site is one day less of an operating theatre out of service.
What does ADAM supply for modular operating theatres?
ADAM S.r.l. has developed its SALUS system, the range dedicated to healthcare environments, since 2006: pre-finished panels with continuous, cleanable surfaces that can be opened for services maintenance, suitable for operating theatres and controlled-contamination environments. Through its ADAM Health division, ADAM supplies not only walls but also medical doors, including hermetic automatic sliding doors, technical ceilings with hermetic lighting, laminar flow units integrated into the ceiling, recessed cabinets, pass-through boxes and X-ray shielding, and integrates monitors, PACS displays and theatre control panels into the walls.
ADAM systems are designed and manufactured at the plant in Bernate Ticino, near Milan, where engineering, aluminium and timber machining, assembly and inspection before shipping are all handled in-house. The full process is described on the Manufacturing page.
Operating theatres fitted with ADAM systems include AMS Private Clinic in the Netherlands, where the walls carry full-wall printed murals, Canavesano Clinic in Italy, FS Hospital in Australia, a paediatric operating theatre in Libya, Kawali Hospital and Ihsan Hospital in Indonesia, and Hôpital de Panzi in the Democratic Republic of the Congo. The current list is on the Projects page: ADAM systems are installed in over 40 countries.
For more detail on the individual elements of the theatre, see the comparison between modular walls and plasterboard in hospitals and the guide to hermetic and lead-lined hospital doors. To discuss a project, contact the ADAM team.