Indicating shortcomings in surgical lighting systems

Abstract

Ergonomic problems of surgical lighting systems have been indicated by surgeons; however, the underlying causes are not clear. The aim of this study is to assess the problems in detail. Luminaire use during 46 hours of surgery was observed and quantified. Furthermore, a questionnaire on perceived illumination of and usability problems with surgical luminaires was issued among OR-staff in 13 hospitals. The results showed that every 7.5 minutes a luminaire action (LA) takes place, intended to reposition the luminaire. Of these LAs, 74% were performed by surgeons and residents. For 64% of these LAs the surgical tasks of the OR-staff were interrupted. The amount of LAs to obtain a well-lit wound, the illumination level, shadows, and the illumination of deep wounds were most frequently indicated lighting aspects needing improvement. Different kinematic aspects of the pendant system of the lights that influence usability were also mentioned: High forces for repositioning, ease of focusing and aiming, ease of moving, collisions of the luminaire, entangling of pendant arms, and maneuverability. Based on these results conclusions regarding the improvement of surgical lighting systems are formulated. Focus for improvements should be on minimizing the need for repositioning the luminaire, and on minimizing the effort for repositioning.

Evaluation of an Improved Suspension System Concept for Surgical Luminaires

“…Complaints of surgeons regarding the usability of surgical lighting [1,2] have been supported with more recent observations of difficulties in luminaire repositioning during surgical procedures in the operating room (OR) [3]. Repositioning duration was used here as an indicator for the occurrence of repositioning problems.…”

“…Due to the possibility of singularity, the force required to reposition the luminaire is dependent on the spatial arrangement of the mechanism [4]. As a result, the surgeon needs more time, more force, and more control effort to position the surgical lights, drawing his attention longer away from the clinical task [3,5]. This was observed to happen during surgery in standing and sitting postures [3].…”

“…The steel bars had a diameter of 25 mm, were 1900 mm in length, and were spaced at 400 mm. The bars were suspended at a height of approximately 1600 mm in an aluminum frame of Minitec profiles, that measures 2000 Â 2000 Â 460 mm 3 . The frame was set on top of two tables at a height of 850 mm, to elevate the center of the vertical movement area to approximately 1700 mm from the floor.…”

A Soft, Biocompatible Magnetic Field Enabled Wireless Surgical Lighting Patty for Neurosurgery

“…The majority of modern surgical lighting illuminates from an external source, a dissecting microscope, into a cavity or is mounted on a surgical instrument, such as retractors, endoscopes, orthoscopic tools, and suction tubes [1][2][3][4][5][6]. However, such conventional implements and instruments are unable to provide sufficient lighting during various surgical procedures.…”

Comparison of modelling and measurement results of spectra emitted by a programmable lamp

“…Moreover, a growing number of applications have emerged that require illumination with the spectra tailored to their individual needs, rather than ordinary white light. The light of a dedicated spectrum is often used in museums, horticulture, industry or healthcare [3][4][5][6]. Due to a large number of possible applications, the light source with a fixed spectral characteristic is not very effective.…”