There are many factors involved when it comes to performing surgery and achieving successful outcomes for patients. In addition to a skilled surgeon and surgical team the surgical instruments and operating room (OR) equipment also plays a critical role. One such area of importance is the lighting systems that illuminate the area of the surgical procedure on the patient and allow for accurate visualization of anatomy.
Poor lighting can be frustrating for the surgeon and the surgical team and even cause delays in a procedure, adding to the mental load and stress of performing surgery. Studies have found that as much as 20 percent of surgical time goes into adjusting the lighting in the operating room. The following elements are important considerations for the effectiveness of a surgical lighting system.
Color Rendition
For most surgeries the anatomy of the patient must be rendered in the most accurate colors possible. Subtle differences in color help guide a surgeon in visually identifying types of tissue and the anatomy they are targeting. Color also acts as a key indicator of healthy vs. unhealthy tissues and fluids.
As we know through our everyday experience colors look different depending on the color of light they are illuminated with. Daylight which is in the range of 5,000-6,500oK, is the gold standard for accurate color rendition of anatomy and OR lighting should fall within this range.
Illuminance
Human blood happens to be a color that absorbs light and makes it harder to illuminate anatomy during open surgeries. Therefore, operating rooms require a higher level of illumination than most other environments. Because of this, the IEC specifies that surgical lights should provide between 40,000 – 160,000 lux at the distance of 1 meter. On the other hand, the light cannot be so bright that it causes glare or momentarily impairs the surgeon’s vision. Both situations can be annoying at the least and dangerous at the worst.
Shadow Management
Managing the risk of shadows is an important factor as well. While you want the surgical area well-lit, you also want to make sure shadows aren’t created that interfere with visibility or change the surgeon’s depth perception.
Volume of Light
A patient’s body isn’t flat, so chances are neither is the area that is being operated on. A light’s volume helps illuminate a 3-dimensional space. This type of factor is especially important when it comes to deep cavity procedures.
Heat Management
No matter what type of light source is used light is energy, and as such it will produce heat. The infrared radiation given off by lighting systems in the OR can cause damage to tissues and dry out vital fluids. Managing the amount of heat that reaches a patient’s exposed skin and tissue is an important consideration for lighting designers. Modern LED lighting has largely eliminated heat concerns because of their high efficacy. Older systems including Incandescent, Tungsten-Halogen, and High-Intensity Discharge (HID) lights all give off differing amounts of infrared radiation and therefore must be used accordingly.
Ease of Use
Lighting will need adjustment during surgery so the surgeons and surgical team must be able to interact with the lighting system efficiently. Controlling the intensity, position, and volume of light should be intuitive and require minimal training and instruction for new users. It is preferred that the surgeon be able to adjust the lighting themselves during a procedure for the most efficient use of time.
Summary
Effective lighting in the OR is one of the most critical factors in the surgical environment. Without the correct type of lighting the risk of surgical errors increases, not because of the surgeon’s skill or knowledge but simply because they may not be able to see what they need to see.
MezLight gives the surgeon a bright, directable, focused light that is sterile and easy to use. The flexible neck is designed so you can bring it into the field when needed and quickly move it out again when it is not. It can be repositioned over and over and holds its position as you left it, giving you handsfree close up illumination.
