Millions of pounds urgently need to be spent to refurbish operating theatres at the Royal Sussex County Hospital in Brighton.
Health bosses want to redevelop three of the six main theatres and build a seventh at the Royal Sussex.
Brighton and Sussex University Hospitals NHS Trust is applying for Government money to pay for the £13 million programme.
It says the 35-year-old theatres need to be radically overhauled to meet new health and safety standards.
The trust warns if something is not done soon the Royal College of Surgeons may eventually class them as unfit for use.
The floors are in poor condition and ventilation, electrical and other engineering services are outdated.
Back-up systems for operating lights have collapsed, which means in the event of electrical failure no lights would be available.
Three of the theatres have already been redeveloped and the trust is keen to bring the rest up to standard as soon as possible.
The extra operating theatre would help the hospital cope with an expected increase in patients as the population continues to age.
It would also help cut waiting times for emergency and non-urgent operations as more operating sessions could be held at the same time.
A hospital spokesman said: "The benefits of this redevelopment include providing a safe and modern environment for operating.
"It would also help us to improve waiting times."
If the trust is given the go ahead, it hopes to start work on the development next April.
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