Preparation of the Operating Room

Abstract

October 2003

Section 1 Basic Surgical and Perioperative Considerations

8 Preparation of the Operating Room

Rene  Lafreniere, M.D., C.M., F.A.C.S.
Professor and Head, Department of Surgery, University of Calgary Faculty of Medicine; and Regional Clinical Department Head of Surgery, Calgary Regional Health Authority, Calgary, Alberta

Ramon  Berguer, M.D., F.A.C.S.
Associate Professor of Surgery, University of California, Davis, School of Medicine

Patricia C. Seifert, R.N.
Perioperative Cardiac Care Coordinator, Inova Fairfax Hospital, Falls Church, Virginia

Michael  Belkin, M.D., F.A.C.S.
Associate Professor, Department of Surgery, Harvard Medical School

Stuart  Roth, M.D., Ph.D.
Staff Anesthesiologist, Good Samaritan Hospital, Baltimore

Karen S. Williams, M.D.
Medical Director, St. Agnes Healthcare, Baltimore

Eric J. DeMaria, M.D., F.A.C.S.
Professor, Division of General/Trauma Surgery, Virginia Commonwealth University Medical College of Virginia, and Section Chief, General and Endoscopic Surgery, and Director, Medical College of Virginia's Hospital for Minimally Invasive Surgery

Lena M. Napolitano, M.D., F.A.C.S.
Associate Professor, Department of Surgery, University of Maryland Medical System, and Director of Surgical Critical Care, Surgical Care Center, VA Maryland Health Care System, Baltimore

This chapter describes certain key aspects of the operating room (OR) environment, with particular attention to emerging technologies and the special OR requirements of endovascular and laparoscopic surgery. Topics discussed include general principles of design and construction (physical layout; voice, video, and data communication); environmental issues (temperature and humidity, lighting); basic safety concerns (hazards to patient, injuries to health care team); equipment (electrosurgical devices, lasers, powered devices, viewing and imaging devices, case carts and storage). This chapter addresses issues of particular relevance to the endovascular OR—such as radiation safety, physical layout, and imaging and interventional equipment—as well as those of particular relevance to the laparoscopic OR—such as physical layout, the laparoscopic surgical team, and equipment (cameras, scopes, touch panels, voice activation devices). Principles of infection control (hand hygiene, gloves and barriers, surveillance, antibiotic prophylaxis, and nonpharmacologic prevention) are reviewed. Housekeeping procedures are summarized. Finally, data management in the OR—including data acquisition, scheduling, and quality improvement—is reviewed. This chapter contains 2 figures, 7 tables, and 84 references.

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