Surgical Suite at Kleysen Institute

The OR/IMRIS surgical suite located in the Kleysen Institute for Advanced Medicine at HSC Winnipeg is the first of its kind in Canada and only one of seven in the world. It is built to house a moveable inter-operative magnetic resonance imaging (MRI) scanner which is developed by a company in Winnipeg and features some of the most advanced technology in the world.

Located on the second floor of the Institute’s six-storey building, the suite consists of four rooms. At the centre is the MRI “garage,” and in front is its control room. To each side are operating rooms, one for neurosurgery and the other for catheter angiography, a procedure used to treat strokes and brain aneurysms. The MRI is mounted on tracks built into the ceiling and can slide into either of the adjoining operating rooms during a procedure.

In the traditional procedures, following an operation the patient undergoes an MRI as a separate procedure to verify that the surgery has been successful, such as to see if all the parts of a tumour have been removed. If not, the patient has to undergo another operation.

In this suite, however, the MRI machine can be moved into either of the operating rooms so that the doctors can see whether any malignant tissue remains as the surgery proceeds and the patient is still “open.”

The dual accessibility to the MRI not only helps patients with improved diagnostics and healing times, but also enables hospitals to schedule MRIs more efficiently. The MRI can also be used for outpatient diagnoses by being accessed from a “clean” corridor.

Creating the infrastructure

“It was a very complicated and demanding project because of all the equipment,” explains Howard Procyshyn, P.Eng. of WSP, who were the prime consultants and the structural, mechanical and electrical engineers. WSP designed the building itself and then were called on two years later to create the 1,000-sq.ft. suite.

First the entire space had to be lined with a copper shield that is independent of the base building concrete construction. The shield is to protect the MRI from electro-magnetic interference. “It looked like the inside of a space ship before they put the drywall on,” says Procyshyn.

The extremely heavy MRI magnet moves on a frame consisting of glulam timber beams and wood stud walls. It is unusual to use wood for structural purposes in hospitals, but steel would have interfered with the machine’s calibration.

Extensive HVAC mechanical and electrical systems were needed to service the suites and these had to be “shoehorned” into the existing space. There are six different electrical rooms, above and below the suite, and in the basement. There are also three separate mechanical rooms located as nearby as possible. The designers took the floor above the suite between floors as an interstitial space to carry all the ducts and power.

Each operating room has to be sterile and so its indoor air must be rapidly purged before and after the MRI machine is used in order to restore a sterile environment. The HVAC systems incorporate HEPA filters and the rooms have individual temperature, pressure and humidity controls, operated by a user touch screen. There is also a heat recovery system.

Fire protection for the suite is critical and includes heat detectors in the interstitial space. These had to be individually located within the complex ductwork in order to be accessible for maintenance.

Any hospital project is complex because of their rigorous design standards, but this was also a pilot project and the OMRIS equipment and controls were being redesigned as the project progressed. WSP had to design and redesign the infrastructure “on the fly” in order to meet the changing demands. The installation took 36 months.

The result, however, is extremely beneficial. Today, the suite is operating almost 12 hours a day, better serving patients with neurological problems, and advancing medical training and research.—BP cce