Proposed specifications of a mobile operating room for far-forward surgery

Proposed specifications of a mobile operating room for far-forward surgery

Can J Surg 2018;61(6):S180-S183 | PDF

CPO John Leasiolagi; PO2 Troy Holton; LCol Kate Doyle, MD; Sgt Laura Parkinson, LPN; Capt (Navy) Raymond Kao, MD; LCol Vivian C. McAlister, MB


Provision of initial surgery to casualties within one hour of injury is associated with better survival. Where evacuation options are limited, surgery within the “golden hour” may have to occur close to the point of injury. Interventions close to the point of injury are limited by the adverse environment. Far-forward surgery has a long history going back to Dominique Larrey of the Napoleonic Army. We reviewed previous reports and used our own experience of far-forward surgery to describe the specifications of the ideal mobile operating room that would address some of these environmental barriers.

Accepted Oct. 3, 2018

Acknowledgments: The authors are grateful for the expert help of David Beck, Matt Hudgins, Jamie Hersey and Rob Russell with elements of this report.

Affiliations: From the United States Navy (Leasiolagi, Holton); and the Canadian Forces Health Services (Doyle, Parkinson, Kao, McAlister).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

Disclaimer: The views expressed in this paper are those of the authors and do not constitute the views or policies of the Canadian Armed Forces.

DOI: 10.1503/cjs.014718

Correspondence to: V. McAlister, University Hospital, Western University, London ON N6A 5A5,