Inside a contemporary operative room

An operating theater (or theatre) was a tiered theatre or amphitheatre in which students and other spectators could watch surgeons perform surgery. Today the term is sometimes used synonymously with operating room (OR) or operating suite, the room within a hospital where surgical operations are carried out today.

[edit] History

Operating theaters had a raised table or chair of some sort at the center for performing operations, and were surrounded by several rows of seats (operating theaters could be cramped or spacious) so students and other spectators could observe the case in progress. The surgeons wore street clothes with an apron to protect them from blood stains, and they operated bare-handed with unsterilized instruments and supplies (gut and silk sutures were sold as open strands with reusable, hand-threaded needles^{[citation needed]}; packing gauze was made of sweepings from the floors of cotton mills^{[citation needed]}). In contrast to today's concept of surgery as a profession that emphasizes cleanliness and conscientiousness, at the beginning of the 20th century the mark of a busy and successful surgeon was the profusion of blood and fluids on his clothes.^{[citation needed]}

In 1884 German surgeon Gustav Neuber implemented a comprehensive set of restrictions to ensure sterilization and aseptic operating conditions through the use of gowns, caps, and shoe covers, all of which were cleansed in his newly-invented autoclave.^[1] In 1885 he designed and built a private hospital in the woods where the walls, floors and hands, arms and faces of staff were washed with mercuric chloride, instruments were made with flat surfaces and the shelving was easy-to-clean glass. Neuber also introduced separate operating theatres for infected and uninfected patients and the use of heated and filtered the air in the theatre to eliminate germs.^[2] In 1890 surgical gloves were introduced to the practice of medicine by William Halsted.^[3] Antiseptic surgery was pioneered in the United States by Charles McBurney.^[4]

[edit] Today

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Contemporary operative rooms are devoid of a theater setting. Rooms are spacious, easy to clean, well lit with typically overhead surgical lights, and may have viewing screens and monitors. Rooms have no windows and a controlled temperature - humidity environment. Special air handlers filter the air and keep rooms slightly pressurized in relation to the outside. Electricity support has backup systems in case of a black-out. Rooms are supplied with wall suction, oxygen, and possibly other anesthesia gases. Key equipment consists of the operating table and the anesthesia cart. In addition, there are tables to set up instruments. There is storage space for common surgical supplies. There are containers for disposables. Outside the operative room is a dedicated scrubbing area that is used by surgeon's, anaesthetist's, ODP's (operating department practitioners), and nurses prior to surgery.

Several operative rooms are part of the operative suite that forms a distinct section within a health care facility. Beside the operative rooms and their wash rooms, it contains rooms for personnel to change, wash, and rest, preparation and recovery rooms(s), storage and cleaning facilities, offices, dedicated corridors, and possibly other supportive units. In larger facilities the operative suite is climate- and air-controlled and separated from the remainder so that only authorized personnel has access.

[edit] Surviving operating theaters

While operating theaters are no longer used for surgery, some still exist. One of the oldest surviving operating theaters is the Old Operating Theatre in London. Built in 1822, it is now a museum of surgical history. But that still exist, the oldest permanent anatomy theater was the University of Padova in Italy, commissioned by the anatomist Girolamo Fabrizio d'Acquapendente in 1594, inside the Palazzo Bo.

Another famous operating theater is the Ether Dome in Boston. Built in 1824, it is now a conference room and tourist attraction.

[edit] In popular culture

• In Lemony Snicket's The Hostile Hospital, Count Olaf disguises his henchmen as doctors and tries to perform a "cranioectomy" (decapitation) on Violet Baudelaire for a live audience in an operating theater.
• In the Seinfeld episode The Junior Mint, Kramer accidentally drops a Junior Mint into the body of the patient, Elaine's boyfriend Roy, who is having a splenectomy. Miraculously, his condition improves and the doctor declares that it came from "something above that day".

[edit] See also

• Anatomical theatre
• Patient identifier

[edit] References