Introduction
When Consultant Hand Surgeon Alex Kocheta went to a British Society for Surgery of the Hand (BSSH) meeting in Glasgow in 2023, he had in mind an idea for a new hand table — something he had be considering for a while.
Models he was currently using in Day Surgery at Rotherham Hospital, (part of The Rotherham NHS Foundation Trust), were old and in need of replacement, but these were no longer in production. To add to his frustration, he felt that what was really needed was not currently available on the market — in fact, the perfect solution didn't exist...
At the meeting, he got into a conversation with Anetic Aid's Product Manager Mark lee, intrigued because the company was showcasing a new hand table which had been a direct collaboration with a surgeon. While this was designed for hand surgery, it was not suitable for his needs, so the idea of seeing his own idea turned into a widely available product was an exciting possibility!
Swift progression to a prototype...
The key elements Mr Kocheta was looking for were a larger surgical surface area than available in current models in combination with the capability to accommodate patients in either sitting or supine positions, the stability needed for complex surgeries requiring heavy equipment like wrist arthroscopy towers — and all with a lighter weight than currently available, to make it easier for theatre staff to handle and set up. Radiolucency would also be a useful feature for both trauma and elective procedures.
With the conversation having crystalized his thinking, he spent time that evening drawing up his idea. Having completed a Master's degree in Orthopaedic Engineering after qualifying in medicine, he was able to use a CAD programme on his laptop to create a workable design.
'I couldn't believe it, I was still at the conference when the file landed in my email' said Mark Lee. 'It was really clear — taking features from our existing design, but with all the additional elements which would create a new variation in table style, filling the one gap in our range.'
Within a few months, the first prototype was ready for trial, and there followed one more version which incorporated a few subtle refinements before 'The Magna' was ready for production.
Said Mr Kocheta: 'I think in pictures, which helped during my engineering degree, and have some experience with 3D design software, so I drew it out and supplied my idea as a technical drawing — the company said that had never happened before!
'The whole experience has been an interesting and exciting process — and very effective. Anetic Aid has been incredibly responsive and I am very proud to have been a part of it — particularly as it is now helping people, both the medical teams and the patients'.
Paying tribute to Rotherham's industrial heritage, and in particular the electric arc melting process used in manufacturing steel, The Magna Hand Surgery Table includes:
Large surgical area - L740mm x W450mm - for patients in sitting or supine position
A laterally-sliding, fixed, fold-away telescopic support leg for easier C-arm access
Lightweight (5.4kg) design - meaning it's easier to set up
Reliability and simplicity - minimal training is needed for staff to use effectively
A collaborative process
Explained Mr Kocheta: 'Some elements were available in existing tables, so it was a matter of putting those together with other refinements. The single point of attachment was important because it enables the table to be angled relative to the operating trolley but the surface kept parallel to the floor when the patient is in a sitting or semi-recumbent position. This may be required for medical reasons (easier breathing etc.) or for comfort, particularly in wide awake surgery either under regional or local anaesthetic.
'But equally, with the range of surgery that we do here, we also need the facility to have the patient in a supine position, and in many cases to have a larger working surface, all of which is radiolucent. The size of the table plate allows the surgeon to rest both hands / forearms comfortably on the table for extended procedures as well as giving adequate space for the placement of instruments / dishes etc.
'Getting the table shape right was particularly important — a tapered end with angled cut outs proximally, to allow orientation of the table towards the main trolley for patient comfort and to take the pressure off the brachial plexus experienced in full shoulder abduction, (but not creating gaps so large that things could drop down onto the floor).
'Greater rigidity of construction and stability is key for us too: I use a wrist arthroscopy ARC tower, which is quite a substantial object. The extra supporting 'leg' on the floor provides that stability and is long enough to accommodate the lying or sitting patient position or the surgeon. The leg is permanently attached to the table so it doesn't get lost when not in use but can be slide to either corner so it doesn't get in the way of a C-arm.
'A slightly longer fitting ensures the hand table plate won't catch against the side of the operating platform, and the depth and supporting bars is also thinner than previous models, allowing for a comfortable seated operating position for the surgeon — it's easier to get your knees under, particularly if you're tall!
'It's been a pleasure to work with Anetic Aid to design and test this product. I am very happy it's now available for widespread use. It's a very satisfying feeling using the finished product that I originally took to Anetic Aid as a drawing.'
The man behind the Magna - meet Alex Kocheta
Consultant Orthopaedic and Hand Surgeon, Alex Kocheta, qualified in medicine from King's College London in 1993, and gained his Fellowship of the Royal College of Surgeons of England in 1997. He also gained his Fellowship of the Royal College of Surgeons in Trauma and Orthopaedic Surgery in 2003.
He completed the University of Cardiff Master's Degree in Orthopaedic Engineering in 2003, achieving a distinction, and undertook Specialist Registrar training in Orthopaedic surgery at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry and its associated hospitals.
As a senior trainee, he completed specialist fellowships in hand and wrist surgery: firstly, at the renowned Pulvertaft Hand Centre in Derby, and subsequently at the world-famous Centre of Excellence for orthopaedic surgery and musculoskeletal disease Wrightington Orthopaedic Hospital in Lancashire.
He was appointed Consultant Orthopaedic and Hand Surgeon at The Rotherham Foundation NHS Trust in 2005, whilst also being the Trust's Associate Medical Director for Medical Education, as well as previously being an examiner for the University of Sheffield Medical School and for the FRCS (Tr. & Orth.) examination.
He says: 'My key aim is to work with colleagues to further improve and widen the scope of upper limb and hand surgery, improve outcomes for patients and their experience.'
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