Surgery without a stay: Ichilov hospital unveils new operating rooms to cut wait times

System supporting 10 new operating rooms uses digital health to offer optimal care without adding beds to hospital’s wards

Renee Ghert-Zand is the health reporter and a feature writer for The Times of Israel.

One of the 10 operating rooms in a new 'mini-hospital' for ambulatory surgery at Tel Aviv Sourasky Medical Center-Ichilov Hospital, February 2024. (Jenny Yerushalmi)
One of the 10 operating rooms in a new 'mini-hospital' for ambulatory surgery at Tel Aviv Sourasky Medical Center-Ichilov Hospital, February 2024. (Jenny Yerushalmi)

Tel Aviv Sourasky Medical Center-Ichilov Hospital has opened a suite of 10 new underground operating rooms for ambulatory surgeries. The facility is undergoing final preparations and medical simulations and will begin serving patients next week.

The new state-of-the-art “mini-hospital” brings Ichilov’s total number of operating rooms to 43, the most in any Israeli medical center, and is expected to shorten the often long waiting periods for relatively short, uncomplicated operations that do not require general anesthetic or pre- or post-operative overnight hospital stays.

The new facility, called Kissufim after one of the Gaza-adjacent kibbutzim where Hamas terrorists carried out their murderous rampage on October 7, has been in the planning for several years.

“The name is deliberate, so there will be no forgetting what year the center was opened,” said Ichilov’s chief of surgery Prof. Idit Matot to a group of visiting reporters on Sunday.

The center cost NIS 100 million ($27.6 million) to build and equip, with funding coming from the Health Ministry, Finance Ministry, and private donors.

Prof. Ronni Gamzu, the hospital’s CEO, said the new center proved it was possible to open new operating rooms without adding a single new bed to hospital wards. He explained how digital and telehealth frameworks that support and guide patients before and after their surgeries made it possible.

From left: Deputy director for nursing Eti Uziel, director of surgery Prof. Idit Matot, and deputy director for operations Ruth Sasportas at the new ‘mini-hospital’ for ambulatory surgery at Tel Aviv Sourasky Medical Center-Ichilov Hospital housing 10 operating rooms and the latest technology, February 2024. (Renee Ghert-Zand/Times of Israel)

“I would like to see projects like this established in all the public hospitals. It’s not a matter of adding new beds. It can be done without this and hospitals need to take action so that waiting times for surgeries [in the public health system] are shortened,” Gamzu said.

According to Matot, 70 new medical professionals — mainly doctors and nurses — were recruited to work in the Kissufim center.

Seven staff members, including two doctors and two nurses, will be in the operating room when a procedure is performed. The entire staff is expected to initially handle 30-50 surgeries per day for now, with patients being admitted only in the mornings. The number of operations is expected to increase once afternoon slots open up.

“The operations that will be done are day surgeries that generally only require regional anesthesia such as nerve blocks, and maybe some sedation. Examples of these procedures are hand and wrist surgeries, ear surgeries for children, hernia operations, and arthroscopic procedures,” Matot said.

One of the 10 operating rooms in the new ‘mini-hospital’ for ambulatory surgery at Tel Aviv Sourasky Medical Center-Ichilov Hospital featuring the latest technology, February 2024. (Jenny Yerushalmi)

Chief of operations Ruth Sasportas noted that the new operating rooms and the hospital as a whole are always prepared to be flexible and responsive to any situation.

“These operating rooms can also be used for surgeries requiring general anesthesia and would be made available in the case of a mass casualty event,” she said.

While showing off the various high-tech amenities of the operation rooms, head nurse Eti Uziel said some of them were designed to make patient information and pre-surgery imaging available right at the surgeon’s line of vision. The screens also allow everyone in the room to see the procedure as it takes place and to communicate online with experts elsewhere in Israel or around the world who could be asked to consult in real time.

The reception and waiting area in the new ‘mini-hospital’ for ambulatory surgery at Tel Aviv Sourasky Medical Center-Ichilov Hospital, February 2024. (Jenny Yerushalmi)

Other design elements are meant to maximize sterility through airflow and other measures. There is also a deliberate focus on sustainability and the recycling of plastic materials that are not biohazards.

To speed up pathology processes, the budget for the new center included the purchase of a million-euro robotic system from Denmark that can slice 384 tissue samples per day. This alleviates the bottleneck that is usually caused by the slicing of pathology samples by hand, thus enabling results to be generated in two or three days rather than weeks.

According to Sasportas, there was no question that the Kissufim center would be built underground. All but a handful of Ichilov’s operating rooms are underground or otherwise fortified against rocket and missile attacks. Ichilov can also open a 1,000-bed underground hospital within hours if necessary.

When war broke out on October 7 as Hamas massacred 1,200 and injured 1,600 Israelis in southern Israel under cover of massive rocket fire, only a third of Israel’s hospital beds and fewer than half of operating rooms were protected against rocket and missile attacks. This meant that nearly all medical staff had to exit unprotected operating rooms and go to safe areas when rocket sirens sound — except during critical lifesaving surgeries.

The Health Ministry announced in mid-November that it had budgeted an additional NIS 200 million ($51.8 million) for the fortification of hospitals against missile and other attacks. This sum augmented the NIS 75 million ($19.5 million) already transferred for this purpose since the outbreak of the war.

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