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By Alan Joch

Memorial Sloan-Kettering Cancer Center, New York City

Architecture and technology blend so closely within two redesigned operating rooms (ORs) at this hospital that it’s difficult to tell where one ends and the other begins. Last fall, the cancer center completed renovations that turned the ORs into high-tech, minimally invasive surgery (MIS) centers, complete with touch-screen computers and sophisticated audio/video gear to guide physicians during delicate operations.

Minimally invasive surgery centers at Memorial Sloan-Kettering are equipped with computers and A/V equipment that allow physicians located elsewhere to watch and advise on procedures.

Surgeons who perform MIS procedures rely on endoscopic cameras, computers, and digital-imaging equipment to treat patients’ abdomens and lungs so as to cause as little trauma to the patients as possible. “[With this technique], information that’s collected and prepared at many other places in the hospital prior to surgery is available to surgeons on a real-time basis,” says Jeffrey Berman, AIA, principal of Jeffrey Berman Architects in New York and an architect for the project. “If they want to see [data from] a CAT scan that was done on a patient two years ago, technicians can bring it right to the surgical field. The surgeon has touchpad [screens] that let him manipulate the images and match them to the area where the surgery is being performed.”

Photography: © John Bartelstone

Within the MIS center, an A/V studio, known as the head-end room, acts as a central data hub, recording each step of the operation for educational purposes. Live images of surgeries being performed can be sent immediately to specialists who may be consulting on the procedure from another part of the hospital or an entirely separate facility.

Shen Milsom & Wilke, a New York technology consulting firm, designed the head-end room. “Today, we put [data, voice, and video] information on the same [telecommunications] network,” says Steven Emspak, a partner in the firm. By sending out this data on the same computer network, the hospital avoided installing multiple lines of similar cables—an efficiency that helped the architects design a less-cluttered OR. The hardware that controls the flow of information required a dedicated space that went beyond the crude networking closets traditionally found in hospitals and office buildings. Instead, the head-end room was born—an environmentally controlled space of more than 1,000 square feet. It is large enough to house all the computer and A/V gear as well as the technicians who direct the cameras while procedures take place.

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The new ORs are less cluttered than their low-tech predecessors. “We accomplished this by thinking through how things work and putting the equipment in the right places,” says Berman. By running cable through the walls rather than over floors, for instance, the room became less treacherous for health care workers to navigate. Lights, camera controllers, and operating equipment were installed permanently onto walls rather than placed on space-hogging mobile carts. “Once you identify the core functionality that the room needs, you can integrate the necessary equipment in much less intrusive ways,” Berman explains.

Berman also considered the ongoing pace of technological change in his design. “We’re building these rooms to be useful for the next five to 10 years, so we considered what we had to do to make them more adaptable,” he said. Through a close alliance between the hospital and Olympus America of Melville, New York, which supplied much of the medical imaging equipment, Berman gained access to prototypes and drawing-board ideas that allowed him to anticipate the evolution of this equipment. One nod to the future was building conduits and easy-access points for installing broadband cables. “The renovation was disruptive,” Berman concedes, “but future upgrades will be plug-and-play.” This is welcome news to Sloan-Kettering, which, like most hospitals, is faced with keeping its facilities up-to-date with budgets that cannot keep pace with innovations in the technological arena.