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Anoperating theater (oroperation theater,OT; also known as anoperating room orOR, as well as anoperating suite oroperation suite) is a facility within ahospital wheresurgical operations are carried out in anaseptic environment.
Historically, the termoperating theater referred to a non-sterile, tieredtheater oramphitheater in which students and other spectators could watch surgeons perform surgery. Contemporary operating rooms are usually devoid of a theater setting, making the termoperating theater a misnomer in those cases.
Operating rooms are spacious, in acleanroom, and well-lit, typically with overheadsurgical lights, and may have viewing screens andmonitors. 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 gasses used during provision of anesthesia. Key equipment consists of theoperating table and theanesthesia 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 bysurgeons,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 andrecovery 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.
People in the operating room wear PPE (personal protective equipment) to help prevent bacteria from infecting the surgical incision. This PPE includes the following:
The surgeon may also wear special glasses to help them 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.
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Early Modern 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 anapron to protect them from blood stains, and they operated bare-handed withunsterilized instruments and supplies.{{Theatre Suction Unit}}
TheUniversity 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.[6]In 1884 German surgeonGustav Neuber implemented a comprehensive set of restrictions to ensure sterilization andaseptic operating conditions through the use of gowns, caps, and shoe covers, all of which were cleansed in his newly inventedautoclave.[7][8] 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 withmercuric 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.[9] In 1890surgical gloves were introduced to the practice of medicine byWilliam Halsted.[10] Aseptic surgery was pioneered in theUnited States byCharles McBurney.[11]
The oldest surviving operating theater is thought to be the 1804 operating theater of thePennsylvania Hospital in Philadelphia.[12] The 1821Ether Dome of theMassachusetts General Hospital is still in use as a lecture hall. Another surviving operating theater is theOld Operating Theatre inLondon.[13] Built in 1822, it is now a museum of surgical history.The Anatomical Theater at theUniversity of Padua, inItaly, 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.[14]
The operating room presents occupational risks and safety challenges. These risks and hazards can affect the well being of the staff who often work in these high pressure environments. There are many risks and challenges that can interfere with surgery in the operating theater that can pose short or long term health risks to the staff. The risks can range from physical strain, equipment related injuries, biohazardous material, and environmental factors. In order to keep the operating theater a safe environment for both staff and the patient, there are strict protocols. These strict protocols are communicated within the surgical team for safety of both staff and the patient. The protocols ensure safe handling of the equipment, proper training from staff, protective measures of biological and physical hazards. This helps greatly reduce harmful exposures as well as injuries. Occupational safety is one of the major two components that focuses on the safety of the staff[15]. Chemical safety is the other major component that addresses anesthetic gasses and hazardous substances that can pose a major problem to the staff and the patient on the operating room table[16].
Occupational safety refers to protecting staff from work related hazards and injuries while on the job. Physical hazards include sharp objects, repetitive movements, static positions, and loud equipment. Surgeons experience the highest rate of work-related musculoskeletal pain compared to other physicians in other specialties due to standing in a static position for long periods of time and using repetitive hand and wrist movements that can lead to muscle fatigue and strain injuries[17] . Surgeons are also at high risks for cuts and stabs due to the amount of sharp objects in an operating theater. Lack of proper equipment, assistance, and safety policies could lead to injuries from sharp objects. The Occupational Safety and Health Administration (OSHA), a United States agency that ensures safe work environments, does not regulate the management of uncontaminated instruments and sharps[18]. To decrease these risks that surgeons face, operating theaters should implement strict safety measures, including ergonomic training, proper equipment handling protocols, and regular safety audits.
Chemical safety refers to safely being able to manage and prevent any exposure to hazardous substances and anesthetic gasses
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