Editing Operating theater

{{Short description|Room in a hospital in which surgeries are performed}}
{{more citations needed|date=June 2017}}
[[File:Operating theatre.jpg|thumb|upright=1.3|Inside a modern Operating Room]]
An '''operating theater''' (also known as an '''Operating Room''' ('''OR'''), '''operating suite''', '''operation suite''', or '''Operation Theatre''' ('''OT''')) is a facility within a [[hospital]] where [[Surgery|surgical operations]] are carried out in an [[asepsis|aseptic]] environment.

Historically, the term "operating theater" referred to a non-sterile, tiered [[theater (building)|theater]] or [[amphitheater]] 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]], and well-lit, typically with overhead [[Surgical lighting|surgical lights]], and may have viewing screens and [[Medical monitor|monitors]]. 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]] and the [[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]]s, [[anesthetist]]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.<ref>{{Cite web|title=Operating Theatres|url=https://www.moduleco.com/healthcare-facilities/operating-theatres/|access-date=2021-06-10|website=ModuleCo {{!}} Manufactured for Life|language=en-GB}}</ref>

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 room]]s, 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===

[[File:Hybrid operating theatre gemelli rome.jpg|thumb|400px|[[Hybrid operating room]] for cardiovascular surgery at [[Agostino Gemelli University Polyclinic|Gemelli Hospital]] in [[Rome]]]]
* The operating table in the center of the room can be raised, lowered, and tilted in any direction.<ref name=steris>{{Cite web|title=Operating Room Equipment: The Complete Guide {{!}} Knowledge Center|url=https://www.steris.com/healthcare/knowledge-center/surgical-equipment/operating-room-equipment-a-complete-guide|access-date=2022-01-19|website=www.steris.com}}</ref>
* The operating room lights are over the table to provide bright light, without shadows, during surgery.<ref name=steris />
* The [[anesthesia machine]] 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.<ref name=steris />
* The anesthesia cart is next to the anesthesia machine. It contains the medications, equipment, and other supplies that the anesthesiologist may need.<ref name=steris />
* Sterile instruments to be used during surgery are arranged on a stainless steel table.<ref name=steris />
* An electronic monitor (which records the heart rate and respiratory rate by adhesive patches that are placed on the patient's chest).<ref name=steris />
* 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.<ref name=steris />
* Automated blood pressure measuring machine that automatically inflates the blood pressure cuff on a patient's arm.<ref name=steris />
* 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.<ref name=steris />
* If surgery requires, a [[heart-lung machine]] or other specialized equipment may be brought into the room.<ref name=steris />
* Supplementary portable air decontaminating equipment is sometimes placed in the OR.<ref>{{cite journal | doi=10.1021/acsomega.2c05570 | title=A Peripherally Located Air Recirculation Device Containing an Activated Carbon Filter Reduces VOC Levels in a Simulated Operating Room | year=2022 | last1=Carroll | first1=Gregory T. | last2=Kirschman | first2=David L. | journal=ACS Omega | volume=7 | issue=50 | pages=46640–46645 | pmid=36570243 | pmc=9774396 }}</ref><ref>{{cite journal | url=https://pubs.acs.org/doi/abs/10.1021/acs.chas.2c00071 | doi=10.1021/acs.chas.2c00071 | title=Catalytic Surgical Smoke Filtration Unit Reduces Formaldehyde Levels in a Simulated Operating Room Environment | year=2023 | last1=Carroll | first1=Gregory T. | last2=Kirschman | first2=David L. | journal=ACS Chemical Health & Safety | volume=30 | pages=21–28 | s2cid=255047115 | url-access=subscription }}</ref>
* Advances in technology now support hybrid operating rooms, which integrate diagnostic imaging systems such as [[MRI]] and [[cardiac catheterization]] into the operating room to assist surgeons in specialized neurological and cardiac procedures.<ref name=steris />

==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<ref>{{Cite web|title=Benefits of Using Disposable Shoe Covers|url=https://www.amazon.com/dp/B08GM8QVLW|access-date=2022-04-22|publisher=[[Amazon (company)|Amazon]]}}</ref>
*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==
[[File:The Agnew Clinic - Thomas Eakins.jpg|thumb|''[[The Agnew Clinic]]'', 1889, by Thomas Eakins, showing the tiered arrangement of observers watching the operation.]]
[[File:Hospital Operating Room (FDA 042) (8250274128).jpg|thumb|right|An operating room in the United States, c. 1960; heart–lung machine with rotating disc oxygenator shown]]
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]] to protect them from blood stains, and they operated bare-handed with [[sterilization (microbiology)|unsterilized]] instruments and supplies.{{Citation needed|date=August 2009}}

[[File:Théâtre-anatomique-Padoue.JPG|thumb|right|The University of Padua houses the oldest surviving permanent [[anatomical theatre]] in Europe, dating from 1595. It was used as an anatomical lecture hall where professors operated only on corpses.]]
The [[University 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.<ref>Jerome J. Bylebyl, "The School of Padua: humanistic medicine in the 16th century," in Charles Webster, ed., ''Health, Medicine and Mortality in the Sixteenth Century'' (1979) ch10</ref>
In 1884 German surgeon [[Gustav Adolf Neuber|Gustav Neuber]] implemented a comprehensive set of restrictions to ensure sterilization and [[Asepsis|aseptic]] operating conditions through the use of gowns, caps, and shoe covers, all of which were cleansed in his newly invented [[autoclave]].<ref>{{cite book | last =Deysine | pages = [https://books.google.com/books?id=A7AzezHNMDUC&pg=PA13 13] | first = M |  publisher = [[Informa|Informa Health Care]] | title = Hernia infections: pathophysiology, diagnosis, treatment, prevention | year = 2003 | isbn = 0-8247-4612-0 }}</ref><ref>{{Cite web|title=Surgeons and surgical spaces|url=https://www.sciencemuseum.org.uk/objects-and-stories/medicine/surgeons-and-surgical-spaces|access-date=2022-01-19|website=Science Museum|language=en}}</ref> 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 [[Mercury(II) chloride|mercuric 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.<ref>{{cite book | last = Bishop | first = WJ | pages = [https://books.google.com/books?id=Yds0EJ3nh8AC&pg=PA169 169] | title = The Early history of surgery | isbn = 1-56619-798-8 | publisher = [[Barnes & Noble]] | year = 1995 }}</ref> In 1890 [[medical glove|surgical gloves]] were introduced to the practice of medicine by [[William Halsted]].<ref>{{cite book | pages = [https://books.google.com/books?id=VsyYXczSmhgC&pg=PA376 376] | title = The Cambridge illustrated history of medicine | first = R | last = Porter | publisher = [[Cambridge University Press]] | year = 2001 | isbn = 0-521-00252-4 }}</ref> Aseptic surgery was pioneered in the [[United States]] by [[Charles McBurney (surgeon)|Charles McBurney]].<ref>{{cite book | title = This day in American history | first = E | last = Gross | year = 1990 | pages = [https://books.google.com/books?id=tQ9eEattl4MC&pg=PA61 61] |isbn = 1-55570-046-2 | publisher = Verlag für die Deutsche Wirtschaft }}</ref>

===Surviving operating theaters===
{{See also| Anatomical theatre}}
[[File:Old Operating Theatre.jpg|thumb|Old Operating Theatre in London]]
The oldest surviving operating theater is thought to be the 1804 operating theater of the [[Pennsylvania Hospital]] in Philadelphia.<ref>{{cite web|url=http://www.uphs.upenn.edu/paharc/tour/tour5.html|title=Pennsylvania Hospital History: Virtual Tour - Surgical Amphitheatre|website=www.uphs.upenn.edu}}</ref>  The 1821 [[Ether Dome]] of the [[Massachusetts General Hospital]] is still in use as a lecture hall. Another surviving operating theater is the [[Old Operating Theatre]] in [[London]].<ref>{{Cite web|title=The Old Operating Theatre|url=https://oldoperatingtheatre.com/|access-date=2022-01-19|website=The Old Operating Theatre Museum & Herb Garret|language=en-US}}</ref> Built in 1822, it is now a museum of surgical history. [[Anatomical Theatre of Padua|The Anatomical Theater]] at the [[University of Padua]], in [[Italy]], 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.<ref>{{Cite web|title=Palazzo Bo and Anatomical Theatre {{!}} Università di Padova|url=https://www.unipd.it/en/palazzo-bo-and-anatomical-theatre|access-date=2022-01-19|website=www.unipd.it}}</ref>

==See also==
* [[Anatomical theatre|Anatomical theater]]
* [[Hybrid operating room]]

==References==
{{Reflist}}

== External links ==

* [https://jwp.io/s/zOTpUMNB Video of a newly-built orthopaedic operating theater in the United Kingdom]
{{Hospital articles}}
{{Authority control}}

[[Category:Surgery]]
[[Category:Hospitals]]