Operating Room Equipment

An operating room may be designed and equipped to provide care to patients with a
variety of conditions, or it may be designed and equipped to provide specialized care to
patients with specific conditions. An operating room includes equipment such as
operating table; operating room lights over the table; patient monitors; diagnostic
devices; respiratory and cardiac support; anesthesia; and emergency resuscitative
devices. Each operating room varies depending on the type of surgery being performed.
Following is a more detailed description of many of the equipment categories typically
found in an operating room.

Operating Table

Operating tables are available in numerous

configurations to fit specific requirements.
Tables are offered in different sizes, electro-
mechanical, hydraulic, remote controlled,
programmable, with radiolucent composite
tabletops, slidable table tops,
interchangeable sections and adjustments
for operating position.

Operating Room Lights

Lighting is considered by many to be the most important element in the operating room.
Without the right lighting it may be possible to miss an important factor that can
dramatically increase the chance of a mistreatment or misdiagnosis.

Traditional halogen lighting is in common use

but many hospitals are transitioning to LED
lighting, especially for major in-patient
procedures. LED lighting offers several
advantages; brighter, better-color light; longer
life (some LEDs are rated at 20,000 hours);
about 70% less energy consumption than
halogen; lower operating temperatures

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increase comfort for the doctor and patient and eliminate the drying of tissue that heat
causes. Next generation lights incorporate an on/off/intensity control switch in a
handle that the surgeon can adjust.

Operating room lights can be ceiling mounted with arms located on tracks or trolleys or
mobile type lamps on stands depending on the surgical procedure. These lights, typically
two to four fixtures, may be extended or retracted as well as slid along a track to provide
the specific focus of light required on the patient.

Patient monitoring equipment

Comprehensive patient monitoring systems can

be configured to continuously measure and
display various parameters via electrodes and
sensors connected to the patient. Parameters
monitored may include the electrical activity of
the heart via an ECG, respiratory rate, blood
pressure (noninvasive and invasive), body
temperature, cardiac output, arterial
hemoglobin oxygen, mixed venous oxygenation,
end-tidal carbon dioxide and BIS.

The pulse oximeter monitors the arterial hemoglobin oxygen saturation of the patient's
blood with a sensor clipped over the finger or toe. An automated blood pressure device
automatically inflates the blood pressure cuff at specified
intervals. In cases with head trauma or other conditions
affecting the brain, intracranial pressure monitors are
connected to sensors inserted into the brain through a
cannula or bur hole. These devices measure the pressure
of fluid in the brain and record or display pressure
trends. Intracranial pressure monitoring may be a capability included in a physiologic
patient monitor.

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Diagnostic Devices

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 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 laboratory.

Respiratory and Cardiac Support

Heart-lung bypass machine, also called a

cardiopulmonary bypass pump, operated by a
perfusionist, takes over for the heart and lungs
during some surgeries, especially heart or lung
procedures. The heart-lung machine removes
carbon dioxide from the blood and replaces it
with oxygen. A tube is inserted into the aorta to
carry the oxygenated blood from the bypass
machine to the aorta for circulation to the body.
The heart-lung machine allows the heart's
beating to be stopped during surgery.

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 The ventilator, also known as a respirator, assists or controls
pulmonary ventilation. Ventilators consist of a flexible
breathing circuit, gas supply, heating/humidification
mechanism, monitors, and alarms. They are microprocessor-
controlled and programmable, and regulate the volume,
pressure, and flow of respiration.

Anesthesia

The anesthesia machine is at the head of

the operating table. This machine has tubes
that connect to the patient to assist in
breathing during surgery. Built-in
monitors help control the mixture of gases
in the breathing circuit. Depending on the
nature of the surgery, various forms of
anesthesia or sedation are administered.
The anesthesia cart, next to the anesthesia
machine, contains the medications,
equipment, and other supplies that the
anesthesiologist may need.

The BIS (Bispectral Index) monitor provides depth of

consciousness and sedation monitoring for the
anesthesiologist. The sensor and monitor measure brain
activity and compute a number between 0 and 100. This
number corresponds to level of consciousness which is
known as the BIS value.

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Emergency Resuscitative Devices

Equipment for life support and emergency

resuscitation includes the crash cart, also known
as the resuscitation cart or code cart. A crash
cart is a portable cart containing emergency
resuscitation equipment for patients who are
"coding", meaning their vital signs are in a
dangerous range. The emergency equipment
includes a defibrillator, airway intubation
devices,
resuscitation
bag/mask, and
medication box.
Crash carts are
located in the operating room for immediate accessibility if
a patient experiences cardio-respiratory failure.

Other operating room equipment

Infusion pumps deliver fluids intravenously or epidurally

through a catheter. Infusion pumps employ automatic,
programmable pumping mechanisms to deliver continuous
anesthesia, drugs, and blood infusions to the patient. The pump
can deliver a wide variety of fluids over a broad range of
infusion rates. The pump hangs from an intravenous pole that is
located next to the patient's bed.

The Intra-aortic balloon pump is a device that helps reduce

the heart's workload and helps blood flow to the coronary
arteries for patients with unstable angina, myocardial
infarction, or those awaiting organ transplants. Intra-aortic
balloon pumps use a balloon placed in the patient's aorta.

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The balloon is on the end of a catheter that is connected to the pump's console, which
displays heart rate, pressure, and electrocardiogram (ECG) readings. The patient's ECG
is used to time the inflation and deflation of the balloon.

Disposable OR equipment includes urinary 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

An increasing number and type of procedures are now being performed with minimally
invasive techniques resulting in better outcomes, enhanced patient safety, less pain,
shorter recovery periods, and (theoretically) reduced costs. Advancements in
communication, information technology, digital imaging, and robotics have also aided
the development of new surgical techniques, allowing surgeons to perform procedures
with greater patient comfort, safety, and accuracy.

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 views a
magnified, high-resolution
3D image of the surgical site.
The equipment uses wristed
instruments through which
state-of-the-art robotic and
computer technologies scale,
filter and seamlessly translate the surgeon's hand movements into precise micro-
movements. Robotic surgery can decrease incision size and length of hospital stay,
while improving patient comfort and lessening recovery time.

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 Lasers are another 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.

The introduction of brain monitors – like the BIS monitor previously mentioned– has
provided anesthesia professionals with another method to help care for their patients.
A BIS monitor is a medical device that measures brain wave activity and provides the
anesthesia professional with information regarding
the patient’s brain during surgery, anesthesia and
sedation. The anesthesia professional can use this
information to adjust the amount of anesthesia
medications administered during the operation.
Finding the right amount is very important –
patients getting too much anesthesia medication are
more likely to have anesthesia side-effects; too little
medicine increases risk of the patient being awake
during anesthesia. Although rare, anesthesia
awareness can be a traumatic, psychologically
debilitating experience for the patient.

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GE Healthcare. Web. 22 Mar. 2011. <http://www.gehealthcare.com/worldwide.html>.

Hillenbrand Industries. Web. 22 Mar. 2011. <http://www.hillenbrand.com/>.

MAQUET Cardiac Assist. Web. 22 Mar. 2011. <http://ca.maquet.com/>.

Surgical and Operating Room Equipment. Web. 22 Mar. 2011.

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