Statistics on surgery malpractice are staggering. For example, a surgeon in the U.S leaves foreign objects, including sponges and towels inside their patients an average of 39 times every week, according to a John Hopkins study.
Proper illumination is a critical requirement for surgical efficiency and improved patient outcomes. Operating rooms need high-quality surgical lighting that meets the IEC 60601-2-41 standards to attain these objectives.
For surgeons, it’s important to observe minute details while performing procedures. Safe and successful surgery needs adequate lighting in the surgical field. Poor quality surgical light can lead to the following negative outcomes:
- Poor surgery outcomes
- Increased malpractice claims
- Eye strain and high surgical staff turnover
- High OR administration costs due to case cancellations and lengthy block times
The right surgical light maximizes visibility while reducing eye fatigue. The lighting systems should strike a balance between brightness, shadow dilution, temperature, and volume. These are the characteristics underscored in the IEC surgical lighting standards.
Illumination
Luminance directly influences visibility on the site of the surgery. Luminance is the measure of the amount of light falling on the surgical field per square meter (measured in lux). Operating lights should have a high luminance but without the risk of eye strain or glare.
The IEC stipulated luminance for surgical lights in the operating field is between 40,000 and 160,000 lux. On the other hand, the illuminance requirement for examination light is 1000 lx. In both these cases, illumination should be uniform to reduce glare and eyestrain.
Shadow and glare management
Shadows in the surgical field are cast by the surgeon’s head, surrounding surgical staff and medical equipment. The right surgical lighting system needs to eliminate shadows either by using multiple light sources or through strategic positioning.
Glare, on the other hand, is the reflectance from bright surfaces near the light sources. Your surgical light source and design should reduce glare, for the latter causes eye fatigue and blurry vision. Placement angles of the lights matter a lot in glare reduction.
Volume
The D50 diameter should be no less than 50% of D10. D10 is the diameter of the light field close to the bright center, where the lux is 10 percent Ec. That means that your light source should be such that 50 percent of its light intensity falls within half of the light’s total diameter.
Surgical lights with multiple light heads can help to attain a sufficient three dimensional kind of lighting needed in the operating room. Similarly, you can merge several light patches of equal illuminance at different heights to create the right lighting field diameter.
Heat Management
Lighting sources emit energy, and without heat management, it can lead to tissue desiccation, which can impact patient recovery. You can employ filters and lenses to reduce heat radiation. LED surgical lights are preferable, for they emit less heat than halogen lights. The IEC states that radiant heat from your surgical lights should not exceed 1000W/m2 at the light patch.
Color Temperature
The color temperature denotes a light source’s color in relation to an ideal light source. The reference daylight color temperature is 5800 Kelvins (K). Surgical light sources can have a color temperature of between 3,000 and 6,700 K, according to the IEC.
Color Rendering
Color rendition, also known as Color Rendering Index (Ra), is the measure of the quality of light, based on how natural colors of objects can be visualized. The daylight’s reference value is 100. Light sources with the best CRI score over 80 Ra. For your surgical lights, the IEC required color rendition index is between 85 and 100 Ra.
Sterilization
Operating rooms require a bacteria-free environment. Your surgical lighting source should be easy to clean and disinfect. It should have a reduced amount of crevices and dust-attracting surfaces.
Integration with Medical Imaging
Your surgical lighting design should be mindful of medical equipment improvements and your future acquisitions. When planning for OR lighting, think of how the light sources would interact with not only your current but also future medical imaging devices and monitors. Regarding this, adjustability, glare, and shadow control are critical issues to ponder.
Key pointers when buying surgical lights
- Adhere to IEC surgical lighting standards
- Think about future advances in surgical technology and the installations fit in an integrated operating room
- Think about durability; the light’s lifespan ends when its brightness drops to 70% of its original value
- LED surgical lights can last for 10-12 years
- Think about minimally invasive and non-invasive operations; these new-age surgeries need in-cavity lighting or lighting attached to surgical tools with video cameras
Types of Surgical Lights
The common types of surgical lighting fixtures include overhead lights, headlamps, and in-cavity lighting
Overhead lights
An overhead light fixture can be incandescent or light emitting diode (LED). The lighting fixture is ceiling or wall-mounted and allows adjustability via sterile handles. A hanging surgical light fixture illuminates the operative field with a high volume of light. The major challenge here is that strategic focus might be hard to achieve with the light sources. Other issues to consider with overhead lights are shadow reduction and heat management.
Headlights
These surgical lights are wearable by the surgeon and medical staff. They provide the physician with the needed mobility and precision in surgical operations. Most headlights are light-emitting diode (LED) fixtures with about 140,000 lux intensity and a color temperature of 6,500 degrees Kelvin. Consider buying battery-powered LED headlights to reduce the risk of tripping on cables.
Surgical Lights on Wheels
Mobile surgical lights are the same as overhead lights except that they are mounted on wheels for easy portability. Like surgical headlights, these light fixtures come with battery power options. When buying these surgical lights, consider their weight, balance, and type of wheels.
In-cavity lighting
In-cavity lighting fixtures are used for visibility deep inside surgical cavities. They supplement overhead and headlamp lighting in non-invasive surgical procedures. The light source is outside the sterile field, often fixed on a surgical instrument. Heat management is the most critical factor of consideration with in-cavity lighting fixtures.
Stationary vs. Non-stationary Surgical Lighting
Stationary surgical lights can be ceiling mounted or wall mounted. The lighting fixture could have one or several headlights. The light fixtures used are mostly incandescent and LED. One of the prominent advantages of stationary surgical lights, including overhead lights, is their minimum disturbance. The lighting hardware is out of the surgeon’s way, and that helps them focus on the job.
However, adjusting stationary light sources requires significant effort on the surgeon’s part. The specialist has to free their hand to adjust brightness. It’s hard to attain the needed focus on the site of the wound. There is also the risk of shadows cast by the surgeon’s head.
Portable surgical lights use light heads similar to those of stationary lights. The only difference is that these light heads are mounted on wheels or wearable. Most non-stationary surgical lights are outfitted with batteries to facilitate free movement. A non-stationary LED light consumes much less energy than stationary light fixtures.
Mobile surgical lighting fixtures such as surgical headlights fix the problems of overhead lights. Being small and wearable (on the head), the surgeon’s free mobility is guaranteed. The quality lighting falls on the site of surgery without the risk of shadows. Adjusting focus is as easy as moving the head closer or further from the surgical site.
The Bottom Line
Proper surgical lighting can help to improve patient outcomes and reduce operating room expenses. Surgical lighting is a dynamic field that advances with technological improvements. Today, surgical headlamps now provide surgeons with high quality light that meets IEC standards and fills gaps in operating room lighting design.