When thoracic surgery is performed with the aid extracorporeal life support (ECLS), a trained perfusion scientist must be present in the operating room until ECLS is terminated with arrangements for their return in an emergency.
The same level of equipment should be available for thoracic surgery as is available in general theatres as specified in chapter 3. Additional specialty specific monitoring is required and is detailed below.3
The standard of monitoring in the operating theatre should allow the conduct of safe anaesthesia for surgery as detailed by the Association of Anaesthetists standards of monitoring.4 Quantitative neuromuscular monitoring is beneficial during Robotic assisted thoracic surgery (RATS) to avoid inadvertent patient movement and injury.
Specific equipment for securing the patient in lateral decubitus position should be available. This may include a shoulder roll, head ring, Carter Brayne arm support, arm boards and table supports for the front and back of the patient. Straps or elastic tape should also be available where used routinely.
Pillows or similar padding should be available and used to ensure pressure and stress areas are adequately padded.
Commonly used forced air warmers, patient under blankets, fluid warmers, foil hats and temperature monitoring should be available.
The patient table should be capable of movements to support the appropriate positioning of the patient for thoracic surgery.
Flowtron boots or equivalent should be available to support the peripheral circulation of patients under anaesthesia in extreme positions.
Flexible fibreoptic bronchoscopy should be immediately available for all patients where lung isolation is used.5
