An operating theater (also known as an Operating Room (OR), operating suite, operation suite, or Operation Theatre (OT)) is a facility within a

hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...

where surgical operations are carried out in an

aseptic Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...

environment. Historically, the term "operating theater" referred to a non-sterile, tiered

theater Theatre or theater is a collaborative form of performing art that uses live performers, usually actors to present experiences of a real or imagined event before a live audience in a specific place, often a stage. The performers may communi ...

amphitheater An amphitheatre ( U.S. English: amphitheater) is an open-air venue used for entertainment, performances, and sports. The term derives from the ancient Greek ('), from ('), meaning "on both sides" or "around" and ('), meaning "place for vie ...

in which students and other spectators could watch surgeons perform surgery. Contemporary operating rooms are usually devoid of a theater setting, making the term "operating theater" a misnomer in those cases.

Classification of operation theatre

Operating rooms are spacious, in a

cleanroom A cleanroom or clean room is an engineered space that maintains a very low concentration of airborne particulates. It is well-isolated, well-controlled from contamination, and actively cleansed. Such rooms are commonly needed for scientifi ...

, and well-lit, typically with overhead surgical lights, and may have viewing screens and

monitors Monitor or monitor may refer to: Places * Monitor, Alberta * Monitor, Indiana, town in the United States * Monitor, Kentucky * Monitor, Oregon, unincorporated community in the United States * Monitor, Washington * Monitor, Logan County, West ...

. 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 anesthetic gases. Key equipment consists of the

operating table An operating table, sometimes called operating room table, is the table on which the patient lies during a surgical operation.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, or sometimes integrated within, is a dedicated scrubbing area that is used by

surgeon In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...

anesthetist Anesthesiology, anaesthesiology or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...

s, 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. 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, 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.

Operating room equipment

* The operating table in the center of the room can be raised, lowered, and tilted in any direction. * The operating room lights are over the table to provide bright light, without shadows, during surgery. * The

anesthesia machine An anaesthetic machine (British English) or anesthesia machine (American English) is a medical device used to generate and mix a fresh gas flow of medical gases and inhalational anaesthetic agents for the purpose of inducing and maintaining anae ...

is at the head of the operating table. This machine has tubes that connect to the patient to assist them 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 patient's chest). * The pulse oximeter machine attaches to the patient's finger with an elastic band aid. It measures the amount of oxygen contained in the blood. * Automated blood pressure measuring machine that automatically inflates the blood pressure cuff on a patient's arm. * An electrocautery machine uses high frequency electrical signals to cauterize or seal off blood vessels and may also be used to cut through tissue with a minimal amount of bleeding. * If surgery requires, a

heart-lung machine Cardiopulmonary bypass (CPB) or heart-lung machine, also called the pump or CPB pump, is a machine that temporarily takes over the function of the heart and lungs during open-heart surgery by maintaining the circulation of blood and oxygen throu ...

or other specialized equipment may be brought into the room. * Supplementary portable air decontaminating equipment is sometimes placed in the OR. * Advances in technology now support hybrid operating rooms, which integrate diagnostic imaging systems such as

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...

and

cardiac catheterization Cardiac catheterization (heart cath) is the insertion of a catheter into a heart chamber, chamber or Blood vessel, vessel of the heart. This is done both for diagnostic and interventional purposes. A common example of cardiac catheterization is c ...

into the operating room to assist surgeons in specialized neurological and cardiac procedures.

Surgeon and assistants' equipment

People in the operating room wear PPE (personal protective equipment) to help prevent bacteria 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 different lasers. a fiber-optic headlight may be attached for greater visibility *Sterile gloves; usually latex-free due to latex sensitivity which affects some health care workers and patients *Long gowns, with the bottom of the gown no closer than six inches to the ground. *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 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.

History

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 an

apron An apron is a garment worn over other clothing to cover the front of the body to protect from liquids. They have several purposes, most commonly as a functional accessory that protects clothes and skin from stains and marks. However, other typ ...

to protect them from blood stains, and they operated bare-handed with unsterilized instruments and supplies. The

University of Padua The University of Padua (, UNIPD) is an Italian public research university in Padua, Italy. It was founded in 1222 by a group of students and teachers from the University of Bologna, who previously settled in Vicenza; thus, it is the second-oldest ...

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. In 1884 German surgeon Gustav Neuber implemented a comprehensive set of restrictions to ensure sterilization and

operating conditions through the use of gowns, caps, and shoe covers, all of which were cleansed in his newly invented

autoclave An autoclave is a machine used to carry out industrial and scientific processes requiring elevated temperature and pressure in relation to ambient pressure and/or temperature. Autoclaves are used before surgical procedures to perform steriliza ...

. 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 with

mercuric chloride Mercury(II) chloride (mercury bichloride, mercury dichloride, mercuric chloride), historically also sulema or corrosive sublimate, is the inorganic chemical compound of mercury and chlorine with the formula HgCl2, used as a laboratory reagent. ...

, 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. In 1890

surgical gloves Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl ch ...

were introduced to the practice of medicine by

William Halsted William Stewart Halsted, M.D. (September 23, 1852 – September 7, 1922) was an American surgeon who emphasized strict aseptic technique during surgical procedures, was an early champion of newly discovered anesthetics, and introduced sever ...

. Aseptic surgery was pioneered in the

United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...

by Charles McBurney.

Surviving operating theaters

The oldest surviving operating theater is thought to be the 1804 operating theater of the

Pennsylvania Hospital Pennsylvania Hospital is a Private hospital, private, non-profit, 515-bed teaching hospital located at 800 Spruce Street (Philadelphia), Spruce Street in Center City, Philadelphia, Center City Philadelphia, The hospital was founded on May 11, 17 ...

in Philadelphia. The 1821

Ether Dome The Ether Dome is a surgical operating amphitheater in the Bulfinch Building at Massachusetts General Hospital in Boston, United States. It served as the hospital's operating room from its opening in 1821 until 1867. It was the site of the first ...

of the

Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is a teaching hospital located in the West End neighborhood of Boston, Massachusetts. It is the original and largest clinical education and research facility of Harvard Medical School/Harvar ...

is still in use as a lecture hall. Another surviving operating theater is the

Old Operating Theatre The Old Operating Theatre Museum and Herb Garret at 9a St Thomas Street, Southwark, St Thomas Street is a museum of History of surgery, surgical history and one of the oldest surviving operating theatres. It is located in the garret of St. Thom ...

London London is the Capital city, capital and List of urban areas in the United Kingdom, largest city of both England and the United Kingdom, with a population of in . London metropolitan area, Its wider metropolitan area is the largest in Wester ...

. Built in 1822, it is now a museum of surgical history. The Anatomical Theater at the

, in

Italy Italy, officially the Italian Republic, is a country in Southern Europe, Southern and Western Europe, Western Europe. It consists of Italian Peninsula, a peninsula that extends into the Mediterranean Sea, with the Alps on its northern land b ...

, 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 Acquapendente is a city and ''comune'' in the province of Viterbo, in Lazio (Italy). Acquapendente is a centre for the agricultural production of vegetables and wine, and has a tradition of pottery craftsmanship. Its ''frazione'' of Torre Alfina is ...

in 1595.

References

External links

Video of a newly-built orthopaedic operating theater in the United Kingdom
{{Authority control Surgery Hospitals