perating theater

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Inside a modern operating room

An operating theater (also known as an operating room (OR), operating suite,
or operation suite) is a facility within a hospital where surgical operations are
carried out in an aseptic environment.

Historically, the term "operating theater" referred to a non-sterile,

tiered theater or amphitheater in which students and other spectators could watch
surgeons perform surgery. Contemporary operating rooms are usually devoid of a
theater setting, making the term "operating theater" a misnomer in those cases.

Operating rooms[edit]
Operating rooms are spacious, in a cleanroom, and well-lit, typically with
overhead surgical lights, and may have viewing screens and monitors. Operating
rooms are generally windowless, though windows are becoming more prevalent in
newly built theaters to provide clinical teams with natural light, and feature controlled
temperature and humidity. Special air handlers filter the air and maintain a slightly
elevated pressure. Electricity support has backup systems in case of a black-out.
Rooms are supplied with wall suction, oxygen, and possibly other anesthetic gases.
Key equipment consists of the operating table and the anesthesia cart. In addition,
there are tables to set up instruments. There is storage space for common surgical
supplies. There are containers for disposables. Outside the operating room, or
sometimes integrated within, is a dedicated scrubbing area that is used
by surgeons, anesthetists, ODPs (operating department practitioners), and nurses
prior to surgery. An operating room will have a map to enable the terminal cleaner to
realign the operating table and equipment to the desired layout during cleaning.
Operating rooms are typically supported by an anaesthetic room, prep room, scrub
and a dirty utility room.[1]

Several operating rooms are part of the operating suite that forms a distinct section
within a health-care facility. Besides the operating rooms and their wash rooms, it
contains rooms for personnel to change, wash, and rest, preparation and recovery
rooms, storage and cleaning facilities, offices, dedicated corridors, and possibly
other supportive units. In larger facilities, the operating suite is climate- and air-
controlled, and separated from other departments so that only authorized personnel
have access.

Temperature and surgical site infections (SSI). The current operating room
design temperature is between 65 and 75 °F (18 and 24 °C).[2][3] Operating rooms are
typically kept below 73.4 °F (23 °C) & room temperature is the most critical factor in
influencing heat loss.[4] Surgeons wear multiple layers (surgical gowns, lead aprons)
and may perspire into an incision if not kept cool; excessive heat may also decrease
concentration and increase the frequency of errors.[4] Higher temperatures increased
subjective physical demand and frustration of the surgical staff.[2] One option is to
heat the patient to prevent surgical site infections (SSI) and keep the surgical team
cool. There is a 3 fold increase in infection for every 1.9 degree Celsius body
temperature decrease because of weakened immune response at lower body
temperatures.[5] Radiation is the major cause of heat loss in patients, and convection
(through air) is the second cause of heat loss.[6] In the first hour, it is common for a
healthy patient’s temperature to decrease 0.5-1.5 °C as anesthesia causes rapid
decrease in core temperature.[6] One study found that the most efficient method of
maintaining normothermia included using warm wraps and a heating blanket
(commercially known as a Bair Hugger).[citation needed] Additionally, pre-warming for thirty
minutes may prevent hypothermia.[4]

Operating room equipment[edit]

 Operating room lights are meant so suppress any
shadow so that the surgeos has a deep light to use while doing procedures. The
surgical light in the picture is the most revolutionary on the market. Thanks to double
reflection technology, an improved version of indirect light, the lamp is able to give a
light without any glare: the main cause of failure or error during procedures. Glare is
the feeling of being blinded given by looking at the light source (the head lamp)

Hybrid operating room for

cardiovascular surgery at Gemelli Hospital in Rome

 The operating table in the center of the room can be raised, lowered, and
tilted in any direction.[7]
 The operating room lights are over the table to provide bright light, without
shadows, during surgery.[7]
 The anesthesia machine is at the head of the operating table. This
machine has tubes that connect to the patient to assist them in breathing
during surgery, and built-in monitors that help control the mixture of gases
in the breathing circuit.[7]
 The anesthesia cart is next to the anesthesia machine. It contains the
medications, equipment, and other supplies that the anesthesiologist may
need.[7]
 Sterile instruments to be used during surgery are arranged on a stainless
steel table.[7]
 An electronic monitor (which records the heart rate and respiratory rate by
adhesive patches that are placed on the patient's chest).[7]
 The pulse oximeter machine attaches to the patient's finger with an elastic
band aid. It measures the amount of oxygen contained in the blood.[7]
  Automated blood pressure measuring machine that automatically inflates
the blood pressure cuff on a patient's arm.[7]
 An electrocautery machine uses high frequency electrical signals to
cauterize or seal off blood vessels and may also be used to cut through
tissue with a minimal amount of bleeding.[7]
 If surgery requires, a heart-lung machine or other specialized equipment
may be brought into the room.[7]
 Supplementary portable air decontaminating equipment is sometimes
placed in the OR.[8] [9]
 Advances in technology now support hybrid operating rooms, which
integrate diagnostic imaging systems such as MRI and cardiac
catheterization into the operating room to assist surgeons in specialized
neurological and cardiac procedures.[7]

Surgeon and assistants' equipment[edit]

People in the operating room wear PPE (personal protective equipment) to help
prevent bacteria from infecting the surgical incision. This PPE includes the following:

 A protective cap covering their hair

 Masks over their lower face, covering their mouths and noses with minimal
gaps to prevent inhalation of plume or airborne microbes
 Shades or glasses over their eyes, including specialized colored glasses
for use with different lasers. a fiber-optic headlight may be attached for
greater visibility
 Sterile gloves; usually latex-free due to latex sensitivity which affects some
health care workers and patients
 Long gowns, with the bottom of the gown no closer than six inches to the
ground.
 Protective covers on their shoes[10]
 If x-rays are expected to be used, lead aprons/neck covers are used to
prevent overexposure to radiation
The surgeon may also wear special glasses that help him/her to see more clearly.
The circulating nurse and anesthesiologist will not wear a gown in the OR because
they are not a part of the sterile team. They must keep a distance of 12-16 inches
from any sterile object, person, or field.

History[edit]

The Agnew Clinic, 1889, by Thomas Eakins, showing

the tiered arrangement of observers watching the operation.
 An operating room in the United States, c. 1960.
Heart-Lung Machine with rotating disc oxygenator
Early operating theaters in an educational setting had raised tables or chairs at the
center for performing operations surrounded by steep tiers of standing stalls for
students and other spectators to observe the case in progress. The surgeons wore
street clothes with an apron to protect them from blood stains, and they operated
bare-handed with unsterilized instruments and supplies.[citation needed]

The University of Padua houses the oldest surviving

permanent anatomical theatre in Europe, dating from 1595, it was used as an
anatomical lecture hall where professors operated only on corpses.
The University of Padua began teaching medicine in 1222. It played a leading role in
the identification and treatment of diseases and ailments, specializing in autopsies
and the inner workings of the body.[11] In 1884 German surgeon Gustav
Neuber implemented a comprehensive set of restrictions to ensure sterilization
and aseptic operating conditions through the use of gowns, caps, and shoe covers,
all of which were cleansed in his newly invented autoclave.[12][13] In 1885 he designed
and built a private hospital in the woods where the walls, floors and hands, arms and
faces of staff were washed with mercuric chloride, instruments were made with flat
surfaces and the shelving was easy-to-clean glass. Neuber also introduced separate
operating theaters for infected and uninfected patients and the use of heated and
filtered air in the theater to eliminate germs.[14] In 1890 surgical gloves were
introduced to the practice of medicine by William Halsted.[15] Aseptic surgery was
pioneered in the United States by Charles McBurney.[16]

Surviving operating theaters[edit]

See also: Anatomical theatre
 Old Operating Theatre in London
The oldest surviving operating theater is thought to be the 1804 operating theater of
the Pennsylvania Hospital in Philadelphia.[17] The 1821 Ether Dome of
the Massachusetts General Hospital is still in use as a lecture hall. Another surviving
operating theater is the Old Operating Theatre in London.[18] Built in 1822, it is now a
museum of surgical history. The Anatomical Theater at the University of Padua,
in Italy, inside Palazzo Bo was constructed and used as a lecture hall for medical
students who observed the dissection of corpses, not surgical operations. It was
commissioned by the anatomist Girolamo Fabrizio d'Acquapendente in 1595.[19]

See also[edit]
 Anatomical theater
 Hybrid operating room

References[edit]
1. ^ "Operating Theatres | ModuleCo | Manufactured for Life". ModuleCo. Retrieved 2021-
06-10.
2. ^ Jump up to:a b Hakim, Mumin; Walia, Hina; Dellinger, Heather L.; Balaban, Onur;
Saadat, Haleh; Kirschner, Richard E.; Tobias, Joseph D.; Raman, Vidya T. (2018-04-
06). "The Effect of Operating Room Temperature on the Performance of Clinical and
Cognitive Tasks". Pediatric Quality & Safety. 3 (2):
e069. doi:10.1097/pq9.0000000000000069. ISSN 2472-0054. PMC 6132757. PMID 30
280125.
3. ^ ANSI/ASHRAE/ASHE Addendum h to Standard 170-2008. (2011). Ventilation of Health
Care Facilities. Retrieved
from https://www.fgiguidelines.org/wp-content/uploads/2015/07/ASHRAE170ad_h.pdf
4. ^ Jump up to:a b c Hart, Stuart R.; Bordes, Brianne; Hart, Jennifer; Corsino, Daniel;
Harmon, Donald (2011). "Unintended Perioperative Hypothermia". The Ochsner
Journal. 11 (3): 259–270. ISSN 1524-5012. PMC 3179201. PMID 21960760.
5. ^ Reynolds, Luke; Beckmann, James; Kurz, Andrea (December 2008). "Perioperative
complications of hypothermia". Best Practice & Research. Clinical
Anaesthesiology. 22 (4): 645–657. doi:10.1016/j.bpa.2008.07.005. ISSN 1521-
6896. PMID 19137808.
6. ^ Jump up to:a b Rosenberger, Laura H.; Politano, Amani D.; Sawyer, Robert G. (June
2011). "The Surgical Care Improvement Project and Prevention of Post-Operative
Infection, Including Surgical Site Infection". Surgical Infections. 12 (3): 163–
168. doi:10.1089/sur.2010.083. ISSN 1096-2964. PMC 4702424. PMID 21767148.
7. ^ Jump up to:a b c d e f g h i j k "Operating Room Equipment: The Complete Guide |
Knowledge Center". www.steris.com. Retrieved 2022-01-19.
8. ^ Carroll, Gregory T.; Kirschman, David L. (2022). "A Peripherally Located Air
Recirculation Device Containing an Activated Carbon Filter Reduces VOC Levels in a
Simulated Operating Room". ACS Omega. 7 (50): 46640–
46645. doi:10.1021/acsomega.2c05570. PMC 9774396. PMID 36570243.
9. ^ Carroll, Gregory T.; Kirschman, David L. (2023). "Catalytic Surgical Smoke Filtration
Unit Reduces Formaldehyde Levels in a Simulated Operating Room Environment". ACS
 Chemical Health & Safety. 30: 21–
28. doi:10.1021/acs.chas.2c00071. S2CID 255047115.
10. ^ "Benefits of Using Disposable Shoe Covers". Amazon. Retrieved 2022-04-22.
11. ^ Jerome J. Bylebyl, "The School of Padua: humanistic medicine in the 16th century," in
Charles Webster, ed., Health, Medicine and Mortality in the Sixteenth Century (1979)
ch10
12. ^ Deysine, M (2003). Hernia infections: pathophysiology, diagnosis, treatment,
prevention. Informa Health Care. pp. 13. ISBN 0-8247-4612-0.
13. ^ "Surgeons and surgical spaces". Science Museum. Retrieved 2022-01-19.
14. ^ Bishop, WJ (1995). The Early history of surgery. Barnes & Noble. pp. 169. ISBN 1-
56619-798-8.
15. ^ Porter, R (2001). The Cambridge illustrated history of medicine. Cambridge University
Press. pp. 376. ISBN 0-521-00252-4.
16. ^ Gross, E (1990). This day in American history. Verlag für die Deutsche Wirtschaft.
pp. 61. ISBN 1-55570-046-2.
17. ^ "Pennsylvania Hospital History: Virtual Tour - Surgical
Amphitheatre". www.uphs.upenn.edu.
18. ^ "The Old Operating Theatre". The Old Operating Theatre Museum & Herb Garret.
Retrieved 2022-01-19.
19. ^ "Palazzo Bo and Anatomical Theatre | Università di Padova". www.unipd.it.
Retrieved 2022-01-19.