Operating theater

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(s), storage and cleaning
facilities, oces, 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.

1.1 Operating room equipment

Inside a modern operating room

An operating theater (also known as an operating

room, operating suite, operation theatre, operation
room or operation suite) is a facility within a hospital
where surgical operations are carried out in a sterile environment. Historically, the term operating theatre referred to a non-sterile, tiered theater or amphitheater in
which students and other spectators could watch surgeons
perform surgery.

Operating rooms

The operating table in the center of the room can be

raised, lowered, and tilted in any direction.

Contemporary operating rooms are devoid of a theater

setting (though some in teaching hospitals may have small
galleries), making the term operating theater a misnomer for the modern facility. Operating rooms are spacious, easy to clean, and well-lit, typically with overhead surgical lights, and may have viewing screens and
monitors. Operating rooms are generally windowless and
feature controlled temperature and humidity. Special air
handlers lter 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 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.

The operating room lights are over the table to provide bright light, without shadows, during surgery.
The anesthesia machine is at the head of the operating table. This machine has tubes that connect to
the patient to assist him or her in breathing during
surgery, and built-in monitors that help control the
mixture of gases in the breathing circuit.
The anesthesia cart is next to the anesthesia machine. It contains the medications, equipment, and
other supplies that the anesthesiologist may need.
Sterile instruments to be used during surgery are arranged on a stainless steel table.
An electronic monitor (which records the heart rate
and respiratory rate by adhesive patches that are
placed on the patients chest).
The pulse oximeter machine attaches to the patients
nger with an elastic band aid. It measures the
amount of oxygen contained in the blood.
1

HISTORY

protective covers on their shoes

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
Hybrid operating room for cardiovascular surgery at Gemelli they are not a part of the sterile team. They must keep a
distance of 12-16 inches from any sterile object, person,
Hospital in Rome
or eld.
Automated blood pressure measuring machine that
automatically inates the blood pressure cu on patients arm.

3 History

An electrocautery machine uses high frequency

electrical signals to cauterize or seal o blood vessels and may also be used to cut through tissue with
a minimal amount of bleeding.
If surgery requires, a Heart-lung machine, or other
specialized equipment, may be brought into the
room. Heart lung machine takes the temporary control of the heart and lung during the surgery maintaining the circulation of blood and oxygen content
of the body
Advances in technology now support Hybrid Operating Rooms, which integrate diagnostic imaging
systems such as MRI and Cardiac Catheterization The Agnew Clinic, 1889, by Thomas Eakins, showing the tiered
into the operating room to assist surgeons in special- arrangement of observers watching the operation.
ized Neurological and Cardiac procedures.

Surgeon and assistants equipment

People in the operating room wear PPE (personal protective equipment) to help prevent germs 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 dierent lasers. a
ber-optic headlight may be attached for greater visibility
vinyl gloves on their hands; latex is used as well, but
much less common due to latex sensitivity which affects some health care workers and patients
long gowns, with the bottom of the gown no closer An operating room in the United States, c. 1960. Heart-Lung
Machine with rotating disc oxygenator
than six inches to the ground.

3
Operating theatres had a raised table or chair of some tourist attraction. Pennsylvania Hospital in Philadelphia
sort at the center for performing operations, and were sur- also boasts its own surviving operating theater, built in
rounded by several rows of seats (operating theatres could 1804.[5]
be cramped or spacious) so students and other spectators
could observe the case in progress. The surgeons wore
street clothes with an apron to protect them from blood 4 Popular culture
stains, and they operated bare-handed with unsterilized
instruments and supplies (gut and silk sutures were sold as
In the "Homers Triple Bypass" episode of The
open strands with reusable, hand-threaded needles; packSimpsons, Homer Simpson has an operation pering gauze was made of sweepings from the oors of cotformed on him in an operating theater.
ton mills). In contrast to todays concept of surgery as a
profession that emphasizes cleanliness and conscientious In Lemony Snicket's The Hostile Hospital, Count
ness, at the beginning of the 20th century the mark of a
Olaf disguises his henchmen as doctors and tries to
busy and successful surgeon was the profusion of blood
perform a cranioectomy (decapitation) on Violet
and uids on his clothes.
Baudelaire for a live audience in an operating theater.
In 1884 German surgeon Gustav Neuber implemented
a comprehensive set of restrictions to ensure steriliza In the Seinfeld episode The Junior Mint, Kramer
tion and aseptic operating conditions through the use of
accidentally drops a Junior Mint into the body of
gowns, caps, and shoe covers, all of which were cleansed
the patient Roy, Elaines boyfriend, who is having a
[1]
in his newly invented autoclave. In 1885 he designed
splenectomy. Miraculously, his condition improves
and built a private hospital in the woods where the walls,
and the doctor declares that, during the operation,
oors and hands, arms and faces of sta were washed with
something staved o [the] infection; something bemercuric chloride, instruments were made with at suryond science...something, perhaps, from above.
faces and the shelving was easy-to-clean glass. Neuber
also introduced separate operating theaters for infected
During a stand-up routine in "The Ex-Girlfriend",
and uninfected patients and the use of heated and ltered
Jerry prefers operations in small rooms as opposed
air in the theater to eliminate germs.[2] In 1890 surgical
to operating theaters: You don't want the doctors
gloves were introduced to the practice of medicine by
doing anything that'll make the other doctors go 'I
William Halsted.[3] Aseptic surgery was pioneered in the
have to see this!'"
United States by Charles McBurney.[4]
Many scenes of the Cinemax series The Knick, set
in the ctional Knickerbocker Hospital in New York
3.1 Surviving operating theaters
City in 1900 and 1901, are set in the hospitals operating theatre, which has tiered seating surrounding the operating table from which other surgeons,
students, or just interested spectators can watch the
surgical procedures.
In the Greys Anatomy episode This Magic Moment, Dr. Meredith Grey refers to the OR as an
operating theatre during the opening narration of the
episode.

5 See also
Old Operating Theatre in London

Anatomical theater
Hybrid operating room

While operating theaters are no longer used for surgery,

some still exist. One of the oldest surviving operating
theaters is the Old Operating Theatre in London. Built
in 1822, it is now a museum of surgical history. Another theater still exists at the University of Padua, in
Italy, inside Palazzo Bo. It was commissioned by the
anatomist Girolamo Fabrizio d'Acquapendente in 1594.
Another famous operating theater is the Ether Dome in
Boston. Built in 1824, it is now a conference room and

Patient identier

6 References
[1] Deysine, M (2003). Hernia infections: pathophysiology,
diagnosis, treatment, prevention. Informa Health Care.
pp. 13. ISBN 0-8247-4612-0.

[2] Bishop, WJ (1995). The Early history of surgery. Barnes

& Noble. pp. 169. ISBN 1-56619-798-8.
[3] Porter, R (2001). The Cambridge illustrated history of
medicine. Cambridge University Press. pp. 376. ISBN
0-521-00252-4.
[4] Gross, E (1990). This day in American history. Verlag fr
die Deutsche Wirtschaft. pp. 61. ISBN 1-55570-046-2.
[5] http://www.uphs.upenn.edu/paharc/tour/tour5.html

REFERENCES

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