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Vol. 29. Num. 4.July - August 2018
Pages 161-216
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Vol. 29. Num. 4.July - August 2018
Pages 161-216
Clinical research
DOI: 10.1016/j.neucie.2018.02.003
Radiation protection measures: Implications on the design of neurosurgery operating rooms
Medidas de protección radiológica: implicaciones en el diseño de quirófanos de neurocirugía
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Pedro David Delgado-Lópeza,
Corresponding author
pedrodl@yahoo.com

Corresponding author.
, Javier Sánchez-Jiménezb, Ana Isabel Herrero-Gutiérrezc, María Teresa Inclán-Cuestac, Eva María Corrales-Garcíad, Javier Martín-Alonsoa, Ana María Galacho-Harrieroa, Antonio Rodríguez-Salazara
a Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, Spain
b Servicio de Radiofísica, Hospital Universitario de Burgos, Burgos, Spain
c Departamento de Enfermería de Neurocirugía, Hospital Universitario de Burgos, Burgos, Spain
d Servicio de Oncología Radioterápica, Hospital Universitario de Burgos, Burgos, Spain
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Figures (7)
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Tables (3)
Table 1. Dose and effective dose rates received in front of the screen at different distances (with or without an apron) and behind it, with the O-arm or with the C-arm.
Table 2. Advantages and disadvantages of the proposed layout of the neurosurgery operating theatre from a radiation protection perspective.
Table 3. Implications of various important matters for radiation protection in the design of multi-purpose neurosurgery operating theatres.
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Abstract
Objective

To describe pros and cons of some radiation protection measures and the implications on the design of a neurosurgery operating room.

Material and methods

Concurring with the acquisition and use of an O-arm device, a structural remodelling of our neurosurgery operating room was carried out. The theatre was enlarged, the shielding was reinforced and a foldable leaded screen was installed inside the operating room. Radiation doses were measured in front of and behind the screen.

Results

The screen provides whole-body radiation protection for all the personnel inside the theatre (effective dose <5μSv at 2.5m from the gantry per O-arm exploration; 0.0μSv received behind the screen per O-arm exploration; and undetectable cumulative annual radiation dose behind the screen), obviates the need for leaded aprons and personal dosimeters, and minimises the circulation of personnel. Enlarging the size of the operating room allows storing the equipment inside and minimises the risk of collision and contamination. Rectangular rooms provide greater distance from the source of radiation.

Conclusion

Floor, ceiling and walls shielding, a rectangular-shaped and large enough theatre, the presence of a foldable leaded screen, and the security systems precluding an unexpected irruption into the operating room during irradiation are relevant issues to consider when designing a neurosurgery operating theatre.

Keywords:
Radiation protection
Screen
Shielding
Operating room
Sievert
Oarm
Resumen
Objetivo

Describir pros y contras de diversas medidas de protección radiológica y sus implicaciones en el diseño de un quirófano de neurocirugía.

Material y métodos

Se realizó una reforma estructural del quirófano de neurocirugía a propósito de la adquisición y uso de un O-arm. Se ampliaron las medidas y blindajes del quirófano, y se instaló una mampara blindada y abatible en su interior. Se midieron dosis de radiación delante y detrás de la mampara.

Resultados

La mampara proporciona una radioprotección integral para todo el personal de quirófano (dosis<5μSv a 2,5 m del gantry por cada exploración con O-arm; 0,0μSv tras la mampara por cada exploración de O-arm; dosis acumulada anual tras la mampara, indetectable), obvia la necesidad de delantales plomados y dosímetros personales y minimiza la circulación de personal. El aumento del tamaño del quirófano permite almacenar los equipos dentro y minimiza el riesgo de colisión o contaminación. Los quirófanos rectangulares permiten aumentar la distancia al foco emisor de radiación.

Conclusiones

El blindaje de paredes, techos y suelos, la forma rectangular y la superficie lo más amplia posible, la presencia de una mampara plomada y abatible, y los sistemas de seguridad que impiden una irrupción inesperada en el quirófano mientras se está irradiando son cuestiones relevantes a tener en cuenta en el diseño del quirófano de neurocirugía.

Palabras clave:
Radioprotección
Mampara
Blindaje
Quirófano
Sievert
Oarm

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