A surgical table is a long-term investment that will typically last 15 to 20 years, so it's critical to buy carefully. To help you find tables that meet your current needs and adapt to a changing case mix, we talked to several table manufacturers about what to look for when you buy.

Think versatility
If you perform a variety of cases, versatility is key. Talk to the vendor about the types of surgical procedures you perform and those you may be planning to add, says Steven Palmer, director of surgical tables and OR business development for Getinge/Castle, Inc. If you elect to purchase a fairly basic, non-specialized model, make sure your manufacturer has an in-depth line of accessories to customize the table, adds Mr. Palmer. Further, make sure your new table and accessories are compatible with the ones you already own, says Randy Tomaszewski, RN/BSN, MBA, of Skytron Medical Equipment.

A basic table should include a height-adjustable four-section articulating top, full side-rails, and a head or foot extension, says Scotty Farris, an equipment planner based in Frisco, Texas. Says Mr. Farris, "These are standard on almost all surgical tables," he says. The difference lies in:

• how much articulation is available
• how the articulations are powered (either manual, hydraulic or electromotor)
• how the articulations are controlled (with buttons on the table, wired or wireless control pendant or by voice activation)
• how the table is powered (manual, plugged into the wall or battery-operated)
• weight capacity
• radiolucency of the top.

Armboards, side-rail clamps and Clark sockets are essential accessories; the latter two items attach the accessories to the table. You may need other accessories based on your physicians' specialties and preferences.

Check imaging capability
Outpatient procedures requiring the use of C-arms have brought about new developments in surgical table technology - radiolucency and maneuverability. "The radiolucency of an outpatient surgical table and the size of the imaging window are extremely important," says Mr. Tomaszewski. Nearly all tables on the market today are at least partially radiolucent. "Most major general surgical tables have imaging windows that offer full body coverage, or close to it," says Mr. Farris, "except for where the table top attaches to the pedestal and along the sides of the patient surface where the radiolucent top is attached to its supporting structural steel framework."

Specialty pain management and vascular tables are available with completely radiolucent tops. These flat diving-board-like tables have no articulation and their surfaces are usually made of a high-tech carbon fiber composite, making them truly radiopaque over the entire surface, says Mr. Farris.

Our experts also recommend purchasing a table that moves longitudinally and laterally to allow visualization of the area that is usually over the pedestal. Says Mr. Tomaszewski, "Today's advanced surgical tables use top slide, top rotation and other functions to help position patients, which often takes more time between and during cases where a C-arm is used." Top rotation allows you to rotate the tabletop 180 degrees on the pedestal without repositioning the patient, and the slide feature allows the table to move from end to end on the pedestal. This feature offers maximum C-arm access with minimum patient and table movement.

Watch your weight
Although almost all new major surgical tables are rated to accommodate a 500-pound patient, be sure to ask the manufacturer if the table can support the weight in articulated positions, not just the flat position. "Weight bearing and articulation capabilities are table priorities which must be considered together, not separately," says Mr. Tomaszewski. "A good surgical table choice should provide 500 pounds of lift and articulation capability throughout all potential articulation functions (including Trendelenberg, reverse Trendelenberg, lateral tilt, height adjustment, flex, reflex, back up and down, leg up and down)."

If you opt to buy a used or refurbished table, check the original manufacturer's rated weight capacity, suggests Mr. Farris. Older tables are usually only rated for 400 pounds or less.

Consider rebuilt and refurbished tables
Before you buy a new table to replace an old one, ask yourself: If the table you currently have were brand new, would it meet your needs? If the answer is yes, says Medrecon president Gary Sitcer, consider having the table rebuilt. If you need to add a table, and you're satisfied with the ones you have, consider purchasing a refurbished model. Rebuilding or buying refurbished offers considerable economic advantages over buying new. According to Mr. Sitcer, to rebuild a table costs one- third of the price of a new table, and a refurbished table will cost 40 to 60% less than a new one.

But beware that the term "refurbished" can have many different meanings. To assure you get what you pay for, Mr. Sitcer advises you do the following:

• Ask the company for local references. According to Mr. Sitcer, almost anyone can give you a good reference, but asking the company to refer you to someone in your area keeps them accountable. Once you get references, call them and ask questions. Find out if the company delivered everything it promised.
• Check with the International Association of Medical Equipment Remarketers & Servicers The International Association of Medical Equipment Remarketers & Servicers (IAMERS) at writeOutLink("www.iamers.org",1). This professional organization investigates complaints about pre-owned medical equipment.

Try before you buy
If at all possible, Mr. Palmer recommends demoing the table in your facility before you buy. "Get input on the product's performance for one to two weeks from your staff and surgeons," says Mr. Palmer. "After all, they will be the ones using the table day in and day out."