History of Surgical Lighting
Three of the most prevalent methods when it comes to surgical lighting are overhead/operating lights (as part of the category of classic surgical lights), headlamps or illuminated loupes, and in-cavity lighting.
CLASSIC SURGICAL LIGHTS
- In 1822, the St Thomas’ Hospital built the first operating theater, and in 1824, in Boston, the Ether Dome was built. The Dome is known to have inspired the modern hospital lighting system as it was used for both operating and teaching and needed excellent lighting systems in place.
- Surgical lights date back to the 1850s originally. In the early days, surgical lights were nothing more than daylight combined with skylights that were used to maximize the amount of light flowing into the room.
- The daylight illumination provided the surgeons with 10,000 lx to 80,000 lx of light depending on the time of day and cloud cover. As the industrial revolution progressed, in the 1850s light bulbs replaced direct sunlight.
- In the 1850s, floor stands for surgical lights were introduced. The 1880s brought ceiling-mounted surgical lights, and early 1990s brought wall-mounted surgical lights. The reason why each of these advancements was made was that surgeries got more extensive and required different angles for lighting due to shading.
- The reason why hospitals were advancing during those times was that cities were facing the need to care for the growing population, as well as taking care of the poor and the elderly.
- By the 1960s, surgeons were using halogen bulbs to increase the amount of light available on the operating table to 100,000 lx. In the 1990s, discharge lamps doubled the available light to 200,000 lx.
- However, the approach of discharge lamps did not lead to more productivity and instead increased eye fatigue and decreased surgeons’ effectiveness. Therefore, starting in 1968 onward, operating rooms are using LED lights more and more considering those lights are able to use less energy to produce nicer, cooler illumination that allows surgeons the visibility they require during advanced surgeries.
- Moreover, LED lights eliminated the problems with radiation that was linked to previous types of lights. Additionally, ORs continue to utilize LED lights, though in different formats than the original ceiling light such as tools, headlamps, and movable positionable lights.
OTHER LIGHTING ASPECTS
- According to research, the use of telescopic loupes (better known as headlights) in general surgery has only become prevalent in the last two decades. In a 2005 lighting and visualization survey, only 16% of general surgeons stated that they always used a headlight.
- In-cavity lighting is the newest method used in operating rooms for getting the best lighting results when dealing with open surgeries. It was introduced in the early 2000s due to the ever-evolving surgical techniques as well as different scope procedures used for diagnosing patients.
- In-cavity lighting includes LED lights during surgery, different probes, and even microchips.
In order to be able to provide a full overview of the different lighting aspects and their introduction into the surgical operating room, we first defined which different lighting aspects exist currently and are considered to be relevant. Surgical lighting mainly consists of classic surgical lights, which can be ceiling-mounted, on a floor stand, or wall-mounted. Additionally, three of the most prevalent methods when it comes to surgical lighting are overhead/operating lights (as part of the category of classic surgical lights), headlamps or illuminated loupes, and in-cavity lighting.