An operating room (OR), also called surgery center, is the unit of a hospital where surgical procedures are performed.
An operating room may be designed and equipped to provide care to patients with a range of conditions, or it may be designed and equipped to provide specialized care to patients with specific conditions.
Operating rooms are sterile environments; all personnel wear protective clothing called scrubs. They also wear shoe covers, masks, caps, eye shields, and other coverings to prevent the spread of germs. The operating room is brightly lit and the temperature is very cool; operating rooms are air-conditioned to help prevent infection.
The patient is brought to the operating room on a wheelchair or bed with wheels (called a gurney). The patient is transferred from the gurney to the operating table, which is narrow and has safety straps to keep him or her positioned correctly.
The monitoring equipment and anesthesia used during surgery are usually kept at the head of the bed. The anesthesiologist sits here to monitor the patient's condition during surgery.
Depending on the nature of the surgery, various forms of anesthesia or sedation are administered. The surgical site is cleansed and surrounded by a sterile drape.
The instruments used during a surgical procedure are different for external and internal treatment; the same tools are not used on the outside and inside of the body. Once internal surgery is started, the surgeon uses smaller, more delicate devices.
An operating room has special equipment such as respiratory and cardiac support, emergency resuscitative devices, patient monitors, and diagnostic tools.
Equipment for life support and emergency resuscitation includes the following:
Patient monitoring equipment includes the following:
The use of diagnostic equipment may be required in the operating room. Mobile x ray units are used for bedside radiography, particularly of the chest. These portable units use a battery-operated generator that powers an x ray tube. Handheld portable clinical laboratory devices, called point-of-care analyzers, are used for blood analysis at the bedside. A small amount of whole blood is required, and blood chemistry parameters can be provided much faster than if samples were sent to the central laboratory.
Disposable OR equipment includes urinary (Foley) catheters to drain urine during surgery, catheters used for arterial and central venous lines to monitor blood pressure during surgery or withdraw blood samples), Swan-Ganz catheters to measure the amount of fluid in the heart and to determine how well the heart is functioning, chest and endotracheal tubes, and monitoring electrodes.
Minimally invasive surgery, also called laparoscopic surgery, is an operative technique performed through a few small incisions, rather than one large incision. Through these small incisions, surgeons insert a laparoscope (viewing instrument that displays the surgery on a computer screen for easier viewing) and endoscopic instruments to perform the surgery.
Robot-assisted surgery allows surgeons to perform certain procedures through small incisions. In robotic surgery, a surgeon sits at a console several feet from the operating table and uses a joystick, similar to that used for video games, to guide the movement of robotic arms that hold endoscopic instruments and an endoscope (small camera). The robotic arms allow the surgeon to perform precise, fine hand movements, and provides access to parts of the body that are difficult to reach manually. In addition, robotic surgery provides a three-dimensional image, and the surgical field can be magnified to a greater extent than traditional or minimally invasive surgery. The goal of robotic surgery is to decrease incision size and length of hospital stay, while improving patient comfort and lessening recovery time.
Lasers are "scalpels of light" that may offer a new alternative for some surgical procedures. Lasers can be used to cut, burn, or destroy abnormal or diseased tissue; shrink or destroy lesions or tumors; sculpt tissue; and seal blood vessels. Lasers may help surgeons perform some procedures more effectively than other traditional methods. Because lasers cause minimal bleeding, the operative area may be more clearly viewed by the surgeon. Lasers may also provide access to parts of the body that may not have been as easily reached manually.
Freestanding surgery centers are available in many communities, primarily for the purpose of providing outpatient surgical procedures. The patient should make sure that the surgery center has been accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a professionally sponsored program that stimulates a high quality of patient care in health care facilities. There is also an accreditation option that is available for ambulatory surgery centers .
Choosing a surgery center with experienced staff is important. Here are some questions to consider when choosing a surgery center:
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Angela M. Costello