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Operating Room 101: What to Expect Before, During & After

6/25/2024

Operating Room: An Overview and the 3 Different OR Types

What is an Operating Room (OR room)?

An operating room (OR) is a designated area within the hospital specifically equipped to perform surgical procedures. Its environment is meticulously controlled to ensure a smooth surgery and also to minimize the risk of infection during the procedure.  

For instance, all OR operating rooms are brightly lit so that surgeons and other medical personnel can see things clearly during the whole process. The rooms are also kept sterile and cool to further prevent the growth of bacteria or other pathogens that could compromise the patient’s safety.

The interior of an operating room

Types of Operating Rooms

Operating rooms are designed to fulfill the specific needs of the procedure and they can be categorized based on the type of surgery performed. Common examples include General ORs, Orthopedic ORs, Neuro ORs, Spine ORs, Urology ORs, and Cardiac/Thoracic ORs.  

Other than that, ORs can also be classified into three different types, integrated, hybrid, or digital, based on their equipment setup, which offer distinct advantages for both patients and medical professionals. We’ll delve into their differences below:

Integrated Operating Room

Integrated operating rooms streamline the workflow by combining the use of lighting, audio, and video, along with the basic surgical equipment. These setups are interconnected and seamlessly controlled by a central console, which improves surgical efficiency as it eliminates the need for constant adjustments or movement of equipment during a procedure.  

The real-time video systems within integrated operating rooms also improve the patient’s safety since they help the medical team to track the current surgical status simultaneously. Furthermore, this can even allow surgeons, specialists, and students to remotely observe surgeries for educational or collaborative purposes.

Hybrid Operating Room

Hybrid operating rooms are multipurpose surgical sites that combine traditional surgical equipment with advanced medical imaging devices, such as CT scanners, C-arms, or MRI scanners, eliminating the need to transport patients between the operating room and separate radiology departments for imaging during complex procedures. 

This setup allows the patient to remain in one location throughout the entire surgical process, which reduces the risk of complications associated with movement. Surgeons can also leverage real-time intraoperative imaging to guide their procedures with the most up-to-date data and maximize the precision of surgery. In turn, this translates to improved surgical outcomes and potentially faster patient recovery times.

Digital Operating Room

Digital operating rooms are focused on data integration and advanced imaging. They utilize a central system that integrates video and audio from the operating field, as well as critical patient data, surgical instrument information, and real-time imaging from various sources. This allows surgeons to visualize and analyze information throughout the procedure, facilitating more informed decision-making. 

Furthermore, these advanced ORs can help securely record, store, and transmit surgical data to the hospital's health record system, allowing a comprehensive review of the surgical procedure for post-surgical assessment and patient care planning. This data can also be anonymized and used for future research, which will contribute to the advancement of surgical techniques and improve patient outcomes.

What Does an Operating Room Look Like? From Equipment to Medical Personnel

What are some of the Equipment Found in a Surgical Operating Room?

While the core function of an operating room remains consistent across healthcare facilities, the specific layout and equipment may vary depending on the size and specialization of the hospital.   

However, some essential equipment is common to most surgical suites, which include:

Essential equipment within an operating room, including medical computer, anesthesia machine, ventilator, etc.
  • Operating Table: It is usually placed in the center of an OR and it is also adjustable, allowing it to be raised, lowered, and titled to accommodate different surgical positions. 
  • Operating Room Lamp: These lamps are designed to provide focused illumination of the surgical field while minimizing shadows, heat and glare. 
  • Vital Signs Monitor: It continuously tracks a patient's heart rate, respiration, blood pressure, and oxygen saturation, allowing the surgical team to closely monitor the patient's condition and make necessary adjustments during the procedure. 
  • Ventilator or Breathing Machine: Depending on the type of surgery, a ventilator may be used to facilitate a patient's breathing during anesthesia by moving air in and out of the lungs.  
  • Sterile Instruments: Various specialized surgical instruments will be sterilized and arranged on a stainless steel table, readily available for each procedure. The specific instruments used will depend on the type of surgery being performed. 
  • Anesthesia Machine: This complex device delivers a precise amount of anesthetic gasses and also helps to monitor the patient's depth of anesthesia throughout the surgery. 
  • Anesthesia Cart: A mobile anesthesia cart keeps frequently used medications and airway management tools organized and within easy reach of the anesthesiologist. 
  • Diathermy or Electrocautery Machine: This device uses electrical currents to cut tissue and control bleeding during surgery. 
  • Medical Computer: A centralized control hub that is used to display patient data, provide real-time imaging, and even control certain automated surgical equipment. 
  • Supplementary Portable Air Decontaminating Equipment: This is a portable air filtration system that is used to minimize airborne contaminants and maintain a sterile environment. 
  • Heart-Lung Machine or Other Specialized Equipment: For complex surgeries, specialized equipment like a heart-lung machine may be necessary to temporarily take over the functions of these vital organs during the procedure.

Who is in the Operating Room During Surgery?

All medical personnel within the OR will be assigned a specific role and work together to ensure a successful outcome for the patient. This team can be broadly categorized into sterile and non-sterile personnel. Sterile personnel are the only ones that will come into contact with the sterile surgical field within the OR. On the other hand, non-sterile personnel will maintain a safe distance from the sterile field to minimize the risk of contamination. 

 The staff present in the room during surgery usually includes:

Sterile Personnel
Non-Sterile Personnel
  • Surgeon
  • Surgical Assistant
  • Scrub Nurse
  • Anesthesiologist
  • Circulating Nurse
  • Technologist
  • Medical Student or Observer
  • Surgeon: The lead doctor of the surgical team who is responsible for planning and performing the surgical procedure. They have undergone extensive training and possess expertise in a specific surgical specialty. 
  • Surgical Assistant: One or more surgical assistants will work alongside the surgeon to provide support and perform specific tasks when instructed. 
  • Scrub Nurse: Scrub nurses are in charge of maintaining a sterile field. They will help prepare surgical instruments and supplies, while ensuring minimal contamination throughout the procedure. 
  • Anesthesiologist: This is a medical doctor specializing in anesthesia administering. They will prevent patients from feeling pain and maintain a safe level of anesthesia during surgery. 
  • Circulating Nurse: Circulating nurses provide logistical support within the operating room by managing supplies, equipment, and communication with the rest of the healthcare team. 
  • Technologist: Depending on the type of surgery, a technologist like an X-ray technician may be present to operate specialized imaging equipment during the procedure. 
  • Medical Student or Observer: In some cases, medical students or observers may be present in the operating room for educational purposes. They will adhere to strict protocols to maintain sterility and will not interfere with the surgical team.

What Do Medical Personnel Wear in a Hospital Operating Room?

Patients may also realize that everyone within the OR dresses the same. This is because these sterile surgical attire are also crucial in minimizing the risk of infections. They will act as a physical barrier between the surgical team and the patient to prevent the transfer of bacteria from the environment or the healthcare worker's skin to the surgical site.  

Here are some of the common pieces of surgical clothing:

A medical staff wearing surgical clothing before the procedure
  • Protective Cap: This disposable cap completely covers the wearer's hair, preventing the hair from falling onto the sterile field. 
  • Face Masks: Surgical masks are worn to cover the mouth and nose, filtering out airborne contaminants that could be expelled through breathing or talking. 
  • Shades or Glasses: Protective eyewear shields the wearer's eyes from splashes of bodily fluids or debris during surgery. Some specialized glasses with colored lenses may be used for laser surgery to ensure greater visibility. 
  • Gloves: These surgical gloves are worn on both hands and may be changed frequently throughout the procedure to maintain sterility. 
  • Long Gowns over their Clothes: Sterile surgical gowns will be worn over scrubs.  They are designed to be fluid-resistant and provide a complete barrier to contamination. 
  • Protective Shoe Covers: Disposable shoe covers are worn over shoes to prevent dirt and bacteria from being tracked into the operating room.

What Happens in the Operating Room Before Surgery?

Before bringing the patient to the operating room, the hospital staff will conduct pre-operative preparation to ensure a smooth workflow while minimizing the risk of complications. 

The steps involved in the surgeon  and medical team’s preparation before surgery are:

  • Medical Team Identification: Each team member will introduce themselves and confirm their roles within the operating room. This doesn’t just prevent unauthorized access to the OR, it is also important in avoiding confusion and ensuring clear communication during the procedure. 
  • Sterilization: The surgical team will thoroughly scrub their hands and arms before wearing sterile attire, following strict protocols at every step to prevent contamination. The operating room itself will also be cleaned and prepped to minimize the risk of infection. 
  • Equipment Preparation: The surgical team will verify that all necessary instruments, medications, and equipment are readily available and functioning properly to ensure a smooth workflow during the procedure. 
  • Rundown of Patient Records: The medical team will review the patient’s records, imaging scans, lab results, allergies, etc, to make sure everyone knows what to expect during the procedure. Traditionally, this is done with paper charts, but the integration of digital All in one PC has offered a more efficient and streamlined approach.

What to Do Before an Operation and What Happens Afterwards?

What is Pre-Op and How Long is Pre-Op Before Surgery?

Patients will be asked to do a pre-op (short for pre-operative) before surgery. This is to help the medical team plan the entire surgery and ensure a safe outcome.  

The procedure and timeframe for pre-op can vary depending on the complexity of the surgery. For simpler procedures, pre-op consultations and tests might be scheduled a few days beforehand, whereas more complex surgeries may involve a series of appointments and tests spread out over weeks. The key steps involved in the pre-op process include:

What to expect for pre-op?
  • Health History Update: The patient will meet with their doctor or a nurse to update their medical history, including information on any recent illnesses, medications they are currently taking, and any allergies they may have. 
  • Vital Signs Check-Ups: The doctor or nurse will check the patient’s vital signs, including their blood pressure, heart rate, temperature, and oxygen saturation.  These baseline readings help evaluate their overall health and suitability for surgery. 
  • Consultation with the Surgeon or Primary Care Doctor:  Patients may have to consult with their primary care physician to ensure that they are suited for surgery. They may also have a chance to meet with the surgeon in charge of their surgery, which offers an opportunity to ask any questions about the procedure, including the risks and benefits involved, and what to expect during recovery.  
  • Meet with the Anesthesiologist: Some surgeries may require a consultation with the anesthesiologist, who will discuss the different types of anesthesia available with the patient and assess the patient’s individual needs, before determining the suitable anesthetic plan for the surgery. 
  • Medical Tests: Patients may need to undergo various pre-operative tests, including X-rays, blood tests, an electrocardiogram (ECG), etc, to assess their overall health and identify any potential concerns.

How are Patients Preparing for Surgery on the Day?

Once the pre-op is complete, the doctor will provide specific instructions based on the patient’s individual situation and the type of surgery being performed.  

For example, if the anesthetic is involved, patients will likely have to avoid eating or drinking anything (except maybe small sips of water) in the hours leading up to surgery; certain medications may need to be stopped or adjusted before surgery as well. It's crucial to follow these instructions carefully to prevent complications. 

On the day of the surgery, patients are usually asked to arrive at the hospital a few hours before the scheduled surgery time. This can help avoid rush during the check-in process, which involves: 

The check-in process at the hospital reception
  • Identification: Hospital staff will verify the patient’s identity using their photo ID and medical records. 
  • Final Pre-Op Assessment: A nurse will take the patient’s vital signs once again and ask them to confirm their medical history, allergy information, and any medications they are currently taking. 
  • Changing Clothes: Patients will have to change into a hospital gown and wear an identification bracelet. 
  • Authorizing Consent Forms and Payment: Patients will be asked to sign consent forms authorizing the surgery and acknowledging the risks and benefits involved. The hospital staff may also discuss any billing or payment details during this time. 
  • Inserting Intravenous Catheter (IV): A thin plastic IV tube will be inserted into a vein in the patient’s arm or hand, allowing the administration of fluids, medications, and anesthesia during surgery. 
  • Transportation to the OR: Once the patient is all prepared for surgery, a staff member will transport them on a stretcher to the operating room.

What will Happen Once the Patient is in the OR?

Now that the patient is in the operation room, there will be some final measures that have to be taken to ensure their safety:

  • Final Identification: The medical team will ask the patient to identify themself one more time to confirm that they are the correct person undergoing the planned surgery. 
  • Patient Positioning: The patient will be carefully positioned on the operating table based on the specific needs of the procedure, which is important in providing surgical access. Padding and support will also be used to ensure comfort and safety. 
  • Attaching Vital Sign Monitors: Small, sticky patches will be attached to the patient's body to monitor vital signs throughout surgery. 
  • Anesthesia Administration: Anesthesia will be administered through the IV line inserted earlier. Depending on the type of surgery, patients may receive general anesthesia, which will render them unconscious, or regional anesthesia, which numbs a specific part of their body.
  • With the preparation complete, the surgery will begin. The time it takes to complete surgery varies greatly depending on the type and complexity of the procedure, so patients will have to consult their doctor for specifications.

Where will Patients be Post-Surgery?

After the surgery, the patient may be placed in a post-anesthesia care unit (PACU) or hospital room for recovery, depending on the complexity of the procedure and their individual recovery progress.

Post-Anesthesia Care Unit (PACU)

In the PACU, specially trained nurses will closely monitor the patient’s vital signs and condition as the patient recovers from anesthesia. If the patient wakes up confused, these staff will be there to help the patient orient themself and answer any questions.  Moreover, the PACU is equipped with appliances and medications that may be required to address any immediate post-surgical concerns, such as unbearable pain, nausea and vomiting, bleeding, erratic breathing, infection, allergic reactions, etc. This ensures a safe and smooth recovery for patients following surgery.

Hospital Room

For less complex surgeries, patients may be transferred directly to a regular hospital room afterward. Similar to a PACU, the nurses will continue to monitor the patient’s recovery progress in the hospital room, while providing pain medication and assistance for the patient’s recovery needs. Some hospitals may equip patient rooms with bedside terminals that allow patients to call for nurses or request assistance with a simple button press, establishing a better way for patients to communicate their needs with the medical staff. 

New Emerging Technology in the Operating Room

The rise of new technologies in surgery has transformed the medical landscape. From centralized medical consoles that visualize real-time data to robotic-assisted surgery offering enhanced precision and virtual reality that aids surgical planning, these innovations are leading to minimally invasive procedures, faster recovery times, and improved patient outcomes. 

Advantech’s iHealthcare solutions are at the forefront of these advancements, providing a comprehensive suite of medical equipment designed to enhance surgical efficiency and safety. Empower your surgical performance with Advantech today!