A comparison of operating room crowding between open and laparoscopic operations

Abstract

The clutter of equipment and lines in today's operating room (O.R.) is increasing. Endoscopic surgical procedures are particularly afflicted by this problem because they require additional equipment. Increasing O.R. crowding may present unnecessary hazards to traffic and adversely affect the performance of the surgical team. The purpose of this study is to provide a quantitative summary of the furniture, equipment, cables, and tubes present during open and laparoscopic operations. We prospectively studied an unselected series of general surgical open (OP, n = 10) and laparoscopic (LAP, n = 10) operations performed at a major university teaching hospital. We recorded the location of all furniture and equipment as well as the source, course, and destination of all cables and tubes in the O.R. Cables and tubes touching the surgeon or the assistant were particularly noted. Results are expressed as median values for each group. The percent of O.R. space occupied increased from OP = 36% to LAP = 41% (p < 0.002). The median number of cables and tubes present increased from OP = 27 to LAP = 34 (p < 0.0002), with the number of these lines touching a member of the surgical team increasing from OP = 2 to LAP = 6 (p < 0.0003). We conclude that there is a significant trend toward increasing O.R. crowding during laparoscopic surgery. Innovative designs will be needed to reduce clutter in the O.R. of the future.