Operating room



Definition

An operating room (OR), also called surgery center, is the unit of a hospital where surgical procedures are performed.


Purpose

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.

Description

OR environment

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.


Operating room equipment

An operating room has special equipment such as respiratory and cardiac support, emergency resuscitative devices, patient monitors, and diagnostic tools.


Life support and emergency resuscitative equipment

Equipment for life support and emergency resuscitation includes the following:

Patient monitoring equipment

Patient monitoring equipment includes the following:

Diagnostic equipment

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.


Other operating room equipment

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.


New surgical techniques

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.


Surgery centers

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:

Resources

books

Deardoff, Ph.D., William and John Reeves, Ph.D. Preparing for Surgery: A Mind-Body Approach to Enhance Healing and Recovery. New Harbinger Publications, Oakland, CA: June 1997. (800) 748-6273. http://www.newharbinger.com/ .

Furlong, Monica Winefryck. Going Under: Preparing Yourself for Anesthesia: Your Guide to Pain Control and Healing Techniques Before, During and After Surgery. Autonomy Publishing Company, November 1993.

Goldman, Maxine A. Pocket Guide to the Operating Room 2nd Edition. F.A. Davis Col, January 1996.


periodicals

"Recommended practices for managing the patient receiving anesthesia." AORN Journal 75, no.4 (April 2002): 849.


organizations

American Board of Surgery. 1617 John F. Kennedy Boulevard, Suite 860, Philadelphia, PA 19103. (215) 568-4000. http://www.absurgery.org/ .

American College of Surgeons. 633 N. Saint Clair Street, Chicago, IL 60611-3211. (312) 202-5000. http://www.facs.org/ .

American Society of Anesthesiologists. 520 N. Northwest Highway, Park Ridge, IL 60068-2573. (847) 825-5586. E-mail: mail@asahq.org. http://www.asahq.org/ .

Association of Perioperative Registered Nurses (AORN, Inc.). 2170 South Parker Road. Suite 300, Denver, CO 80231. (800) 755-2676 or (303) 755-6304. http://www.aorn.org/ .

National Heart, Lung and Blood Institute. Information Center. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 251-2222. http://www.nhlbi.nih.gov .

National Institutes of Health. U.S. Department of Health and Human Services, 9000 Rockville Pike, Bethesda, MD 20892. (301) 496-4000. http://www.nih.gov .


other

preSurgery.com. http://www.presurgery.com .

Reports of the Surgeon General. National Library of Medicine. http://sgreports.nlm.nih.gov/NN/ .

SurgeryLinx. (surgery medical news and newsletters from top medical journals). MDLinx, Inc. 1025 Vermont Avenue, NW, Suite 810, Washington, DC 20005. (202) 543-6544. http://sgreports.nlm.nih.gov/NN/ .

Surgical Procedures, Operative. (collection of links). http://www.mic.ki.se/Diseases/e4.html .


Angela M. Costello



User Contributions:

1
mina
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Jan 5, 2009 @ 10:10 am
it is very god article and it was very helpful to me
2
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Jun 15, 2010 @ 6:06 am
we are about to exposed OR this semester probably next week.. thanks a lot!! i assure you this could help me! god bless ..
3
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Nov 7, 2010 @ 3:03 am
very good, next time if you have more about operating room i would like to have yours
4
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Jan 9, 2011 @ 2:14 pm
thanks for this informative subject,but loose apicture for theatre.send me samples for theatres with best regards.
5
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Feb 17, 2011 @ 5:05 am
im just curious..is there such thing wherein OR instruments like clamps or scissors are left inside the patient's body to stop the bleeding? is that what you call damage control? thank you
6
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Mar 25, 2011 @ 10:10 am
tomorrow i will go to asssit a surgery with my seniors and i think this all information is very important for me.thanks
7
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Mar 27, 2011 @ 5:05 am
Praise God i can catch this website... tomorrow i'll practice in the OR for the first time.
8
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Apr 24, 2011 @ 7:19 pm
very helpful article,,
i'm an architecture student and still working to finish my hospital design,
would you give me an advice about "should and should not" thing in designing O.R?
thanks anyway,,
9
dormaida
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Jun 17, 2012 @ 5:17 pm
it is very goods article, and i hope this wedsite sucses to allways.
thanks anyway..
10
spook
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Sep 27, 2012 @ 12:00 am
i would like to know more specific operating room technique procedures
11
Don S
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Jan 23, 2013 @ 10:10 am
I have read several of your articles and find them very helpful. But I read slowly and retention is poor. I learn best with clear large pictures and retention is much better.
I have PAD,ED and Diabetes II. I have two stents on the heart and 12 inches of the left femur was reamed. It helped for six months but the walking pain has returned.
Thank you for the good articles... Don S
12
John
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May 17, 2013 @ 9:09 am
Having working worked in and around Operating rooms for the past 12 years has taughted me way more than you would ever expect. If you are interested in learning about life, function and the different rolls members play in the surgical enviroment... visit your local hospital! Most facilities have visitor programs where you can watch (but not help) in the operating room...

Check it out and good luck!

I have serveral friends that are in designed and constructing hospitals! Very rewarding job... but very challenging!

John

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