A comparison of operating room crowding between open and laparoscopic operations
- 93 Downloads
Background: The clutter of equipment and lines in today's operating room (O.R.) is increasing. Endoscopic surgical procedures are particularly afflicted by this problem because they require additional equipment. Increasing O.R. crowding may present unnecessary hazards to traffic and adversely affect the performance of the surgical team. The purpose of this study is to provide a quantitative summary of the furniture, equipment, cables, and tubes present during open and laparoscopic operations.
Methods: We prospectively studied an unselected series of general surgical open (OP, n=10) and laparoscopic (LAP, n=10) operations performed at a major university teaching hospital. We recorded the location of all furniture and equipment as well as the source, course, and destination of all cables and tubes in the O.R. Cables and tubes touching the surgeon or the assistant were particularly noted. Results are expressed as median values for each group.
Results: The percent of O.R. space occupied increased from OP=36% to LAP=41% (p<0.002). The median number of cables and tubes present increased from OP=27 to LAP=34 (p<0.0002), with the number of these lines touching a member of the surgical team increasing from OP=2 to LAP=6 (p<0.0003).
Conclusions: We conclude that there is a significant trend toward increasing O.R. crowding during laparoscopic surgery. Innovative designs will be needed to reduce clutter in the O.R. of the future.
Key wordsOperating room design Human factors Laparoscopy
Unable to display preview. Download preview PDF.
- 1.(1987) Guidelines for construction and equipment of hospital and medical facilities. The American Institute of Architects Press, Washington, DCGoogle Scholar
- 2.(1994) Endosuite (videotape). Stryker EndoscopyGoogle Scholar
- 3.Boyers SP (1991) Operating room setup and instrumentation. Clin Obstet Gynecol 34: 373–386Google Scholar
- 4.Green FL, Taylor NC (1994) Operating room configuration. Laparoscopic surgery. W.B. Saunders, Philadelphia, pp 34–41Google Scholar
- 5.Johnston IDA, Hunter AR (1984) Preface, The design and utilization of operating theatres. Edward Arnold, London, p 9Google Scholar
- 7.Kaplan K, Hunter I, Durlach NI, Schodek DL, Rattner D (1995) A virtual environment for a surgical room of the future. Interactive technology and the new paradigm for healthcare. 1, ed, I.O.S. Press, San Diego, pp 161–167Google Scholar
- 8.Kernaghan SG (1982) Technology and the surgical suite: forest of instrumentation improves, but complicates, surgical practice. Hospitals 56: 101–105Google Scholar
- 9.Klebanoff G (1979) Operating-room design: an introduction. Bull Am Coll Surg 64: 6–10Google Scholar
- 10.Laufman H (1971) What's wrong with our operating rooms? Am J Surg 122: 332–343Google Scholar
- 11.Laufman H (1974) Architectural and engineering aspects of the operating room environment. Bull Soc Int Chir 33: 1–10Google Scholar
- 12.Laufman H (1994) Streamlining environmental safety in the operating room: a common bond between surgeons and hospital engineers. Health Facil Manag Ser 1-14Google Scholar
- 13.Nora PF (1976) OR environment: a surgeon's view. Am Operating Room Nurse J 24: 266–267Google Scholar
- 14.Putsep E (1973) Planning of surgical centres. Lloyd-Luke, LondonGoogle Scholar
- 15.Quebbeman EJ (1993) Preparing the operating room. Care of the surgical patient: a publication of the committee on pre and postoperative care. Sci Am 5: 1–13Google Scholar
- 16.Rogers P (1982) Operating theatre feature: some guidelines. Hosp Dev 10: 30–32Google Scholar
- 17.Slaney G (1984) Foreword. The design and utilization of operating theatres. Edward Arnold, LondonGoogle Scholar
- 18.Smith H, McIntosh P, Sverisdottir A, Robertson C (1993) Improved coordination makes for faster work. Ergonomic analysis of a trauma resuscitation room. Prof Nurse 8: 711–715Google Scholar
- 19.Smith W (1960) Planning the surgical suite. F. W. Dodge, New YorkGoogle Scholar
- 20.Wilder RJ, Williams GR (1981) The ceiling-retractable service column [letter]. JAMA 246: 1403–1404Google Scholar