Operating Theatre Research Articles

Role of the WHO Surgical Safety Checklist in Reducing Morbidity and Mortality Among Obstetrics and Gynecology Patients Undergoing Surgery: A Prospective Comparative Study.

As surgery is an essential aspect of healthcare around the globe, it is necessary to consider complications related to it. Therefore, this study was conducted to evaluate the impact of the World Health Organization Surgical Safety Checklist (WHO SSC) on reducing the incidence of postoperative complications Methods: This single-center, prospective, comparative study was conducted at the Department of Gynecology and Obstetrics in a government hospital in Patna, Bihar. To assess the efficacy of the WHO SSC, the patients were divided into two groups, in which one group undergoing surgery was assessed with the checklist, and the other group was not. The rates of surgery-related complications were then compared in both groups. Our results showed a reduction in surgery-related complications in patients assessed with the WHO SSC. No statistically significant difference in duration of surgery was found between the groups. However, a statistically significant difference was observed in the rates of surgery-related complications between groups, especially in sepsis (p=0.0009), hemorrhage (p<0.0001), and infection at the site of surgery (p<0.0001). Mortality rates were not affected by the use of the SSC. The WHO SSC is a simple yet effective tool for reducing postoperative complications by improving communication between the various team members working in the operation theatre, although it has no effect on reducing mortality. Further research is needed to enhance its successful implementation and ensure its sustained use.

Enhancing Surgical Safety: Microbiological Air Control in Operating Theatres at University Medical Centre Maribor.

the aim of the study was to assess microbiological air quality in operating theatres by determining the level of microbiological contamination of the air and critical surfaces using the passive air sampling method and compliance of the operating theatre staff with infection control measures. The prospective study was conducted in the surgical block of the University Medical Centre Maribor. For two months continuously, ten operating theatres were assessed for microbial contamination of air and surfaces during quiet and active times of the day. A passive air sampling method with Petri dishes on an agar specially adapted for this purpose (plate count agar) was used. In addition, ten surgical procedures were observed to assess staff compliance with recommended practises. Air samples met microbiological standards in all operating theatres. In both sampling sessions of the day (quiet and active periods), microbial contamination of the air was always within the limit of 10 CFU/m3. The average number of bacterial colonies was zero to two during quiet phases and one to four during active phases. Approximately 60% of the isolates from the operating theatres belonged mainly to the genus Staphylococcus: S. epidermidis (36% of the isolates), S. hominis (17.5%) and S. haemolyticus (5.5%). The rest were identified as Streptococcus anginosus (23%) and Bacillus sp. (18%). Pathogenic bacteria and moulds were not present. In regard to staff compliance with good surgical practise, the former varied by behaviour and function, with non-compliance in pre-operative skin preparation and operating theatre congestion being notable. The cleanliness of the environment was satisfactory. Microbiological air control is extremely important for the safety and success of both surgical and postoperative practises. In spite of good results obtained in the study, further improvements in surgical staff compliance with good surgical practise are essential to reduce surgical site infections.

Emergency Haemorrhoidectomy in Acute Haemorrhoidal Crisis: A Tertiary Centre Experience

Acute haemorrhoidal crisis refers to painful, irreducible prolapsed haemorrhoids. On the best of hand, surgical treatment of acute haemorrhoidal crisis could still risk complications of bleeding and worse, incontinence. Our study aimed to look at the short-term outcomes of emergency excisional haemorrhoidectomy for acute haemorrhoidal crisis at a colorectal centre. This is a retrospective study conducted at a tertiary centre in the northern state of Malaysia from January 2015 to December 2020. The medical record was traced from the medical record unit and the operation theatre list for all patients with surgical treatment for an acute haemorrhoidal crisis. Sociodemographic data and complications rate were collected with 12 months follow-up. There were 51 patients identified from the registry and 29 out of those were male. The median age was 41 (20-82) years old. In addition, 26% (n=13) of the females were pregnant at presentation. Five patients had previous haemorrhoidal procedures performed. The median operating time was 35 (15-143) minutes with the length of hospital stays of 4 (2-10) days. The early complications were seen in 17 patients with bleeding (5.9%) and urinary retention (27%). The 12-month recurrence rate was 7.8% with median Wexner incontinence scores of 0 (0-3). The emergency excisional haemorrhoidectomy in acute haemorrhoidal crisis is safe and effective for immediate symptomatic relief with an acceptable low self-limiting complication rate.

Effectiveness of Segmental Thoracic Spinal Anaesthesia in Breast Surgery: An Observational Study

Effectiveness of Segmental Thoracic Spinal Anaesthesia in Breast Surgery: An Observational Study

Improving Environmental Sustainability of Operating Theatres: A Systematic Review of Staff Attitudes, Barriers, and Enablers.

To understand views of staff in relation to attitudes, enablers, and barriers to implementation of environmentally sustainable surgery in operating theatres. This will ultimately help in the goal of successfully implementing more sustainable theatres. Global healthcare sectors are responsible for 4.4% of greenhouse gas emissions. Surgical operating theatres are resource intensive areas and improvements will be important to meet Net-Zero carbon emissions within healthcare. Three databases were searched (Web of Science, Ovid and PubMed), last check January 2024. We included original manuscripts evaluating staff views regarding sustainable operating theatres. The Mixed Methods Appraisal Tool was used for quality appraisal and data analysed using thematic synthesis. 2933 articles were screened and 14 fulfilled inclusion criteria, using qualitative (1), quantitative (2), and mixed methods (11). Studies were undertaken in a variety of clinical (Department of Anaesthesia, Surgery, Otolaryngology, Obstetrics & Gynaecology and Ophthalmology) and geographical settings (Australia, Canada, France, Germany, New Zealand, USA, UK & Ireland,). Across studies there was a lack of evidence exploring enablers to implementation, but barriers mainly related to the following themes: education and awareness, leadership, resistance to change, facilities and equipment, time, and incentive. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice.

PREPARATION TIMES FOR ELECTIVE ORTHOPAEDIC SURGERY

IntroductionThis study aimed to assess the relationship between preparation times and operative procedures for elective orthopaedic surgery. A clearer understanding of these relationships may facilitate list organisation and thereby contribute to improved operating theatre efficiency.MethodsTwo years of elective orthopaedic theatre data was retrospectively analysed. The hospital medical information unit provided de- identified data for 2015 and 2016 elective orthopaedic cases, from which were selected seven categories of procedures with sufficient numbers to allow further analysis - primary hip and knee replacement, spinal surgery, shoulder surgery (excluding shoulder replacement), knee surgery, foot and ankle surgery (excluding ankle replacement), Dupuytrens surgery and general orthopaedic surgery. The data analysed included patient age, ASA grade, operation, operation time, and preparation time (calculated as the time from the start of the anaesthetic proceedings to the patient's admission to Recovery, with the operating time [skin incision to skin closure] subtracted). Statistical analysis of the data was undertaken.ResultsA total of 1596 procedures performed over the two year period were analysed. Preparation times for the different procedures were assessed, along with the relationship to the procedure complexity. Neither age nor ASA correlated strongly with preparation times. Spine procedures had greater preparation times than hip and knee arthroplasty. Greater uniformity in preparation times for hip and knee arthroplasty was seen across the anaesthetic group than operative times across the surgeon group.DiscussionPreparation times are just one aspect that may be evaluated with regard to theatre utilisation. This study did not address the theatre turn-over time between cases, which includes transfer of the patient from the admitting/pre-operative area into the theatre.ConclusionPreparation times for elective procedures follow a pattern which may be used to inform list planning, with the potential for greater theatre efficiencies with regard to list utilisation and staff allocation.

Osteotomy Le fort I as a Treatment option for class III Dentoskeletal Problem

Introduction: Orthognathic surgery is surgery to correct the jaw relation and which aim to correct dentoskeletal deformities and a treatment option for severe deformity that cannot be corrected by orthodontic treatment alone. Le fort I osteotomy is a technique in orthognathic surgery that aims to correct the maxilla. In its management, it is possible for correction of the maxilla and mandible to achieve an optimal jaw relation, function and esthetics. Case report: This case report explained a patient with maxilla retrognathism accompanied by function and aesthetic problems. This patient was diagnosed with class III dysgnathy and was performed orthognathic surgery treatment with le fort I osteotomy technique under general anesthesia at Central Operating Theater at Hasan Sadikin General Hospital, Bandung, and was evaluate periodically after the surgery. Conclusion: In this case, the patient's function and aesthetic problems was corrected without causing any postoperative complications. Careful planning with a good calculation and treatment plans are important for obtaining a good result. Keywords: Le fort I osteotomy, class III disgnathy, dentoskeletal deformity

Ultrasound monitoring to detect embolic phenomena in the inferior vena cava during hip arthroplasty

Introduction and objectivesEmbolic phenomena frequently occur during hip joint replacement surgery, and may lead to haemodynamic instability in frail patients. Transoesophageal ultrasound monitoring is rarely available in non-cardiac operating theatres, and cannot be performed in awake patients under spinal anaesthesia. The main objectives of this prospective exploratory study were to determine the feasibility of using an alternative ultrasound approach to monitor the inferior vena cava during hip replacement surgery, and to determine the intra and interobserver reliability of the ultrasound findings. MethodWe conducted a prospective exploratory study in 20 patients undergoing cemented hip arthroplasty in the supine position under spinal anaesthesia and sedation. The inferior vena cava was assessed through a subcostal window at 10 intraoperative time points, and the findings were rated on a qualitative embolism severity scale. The ultrasound images were evaluated by 2 independent observers. ResultsAn adequate subcostal window was obtained in 90% of cases. Intra- and inter-observer reliability was high (kappa index >0.80, p < 0.001). Nearly all (95%) patients presented some degree of embolism, which was severe in 50% of cases. ConclusionsOur study suggests that ultrasound assessment of embolic phenomena in the inferior vena cava through a subcostal window is feasible in 90% of cases. The qualitative embolic severity rating scale is highly reproducible and has high intra- and inter-observer reliability.

50 Years of Existence of X-rays in Orthopedic Operation Theater: A Review

Abstract The radiation hazards evaluation is very important for justifying and ensuring satisfactory protection. The surgeon may receive exposure to the hands from the primary beam and to the rest of the body from the scattered beam. In academic institutions, one should always keep in mind that surgeons-in-training and technicians may be exposed to excessive radiation. One has to be also very careful with pediatric and pregnant patients. The radiosensitivity of pediatric patients is 10 times more compared with adults. Issues concerning X-ray exposure should be understood in the correct perspective and it should not create undue apprehension in the minds of surgeons, which will forbid the optimum use of this invaluable modality. It is very important that practitioners should be aware of the effective dose and should ensure that they use it wisely and effectively. The International Commission on Radiological Protection recommendation identified two types of effects against which protection is required. “Stochastic” effects are those for which the probability of an effect occurring, rather than its severity, is regarded as a function of dose without threshold, whereas “non-stochastic” (deterministic) effects are those for which the severity varies with the dose and for which a threshold may occur. Most importantly a piece of practical advice to orthopedic surgeons and operation theater personnel for optimum radiation protection should be given as reported by various authors. Recommended limits of exposure to ionizing radiation as advised by the National Council on Radiation Protection are updated from time to time as new information becomes available. Radiation protection infrastructure in India is constantly being strengthened based on experience and continued research and development activities at Bhabha Atomic Research Centre (BARC), Mumbai, and is keeping pace with the increasing use of radiation in radiotherapy, diagnosis, nuclear medicine, and industrial radiography. BARC has developed in-house thermoluminescent dosimeters (TLDs) and an automatic reader system for occupational radiation monitoring. Personnel monitoring of over 70,000 occupational workers is carried out using TLD.

EFFECTIVENESS OF COMPREHENSIVE BODY MECHANICS ON LOW BACK PAIN AMONG STAFF NURSES WORKING IN CRITICAL CARE UNIT AND OPERATION THEATER

Introduction:Low Back pain can affect the people from any age and any different reasons. As people gets older, the chance of developing chromic low back pain. Low back pain occur in the area of bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. Aims: To assess the level of low back pain among staff nurses before and after comprehensive body mechanics among staff nurses. To assess the effectiveness of comprehensive body mechanics on low back pain among staff nurses. To find association between post interventional level of low back pain with the selected demographic and clinical variables among staff nurses. Methodology:Aquasiexperimentalstudywith one group pre test andposttestdesignwasselectedtoassesstheeffectivenessofcomprehensive body mechanics on low backpainamong staff nurses working in Critical care unit and Operation Theater.Samples were selected by using non probability convient sampling technique as per theinclusioncriteriaatBharathirajaa Hospital,T Nagar,Chennaiand the sample size is 60 staff nurses, and were 30 staff nurses from critical care unit and 30 from Operation theater were selected for Pre and Post test. Assessment of low back pain was done by numerical rating pain scale and comprehensive body mechanics were educated to the staff nurses and post test of low back pain was assessed bythe investigator andanalyzedusingDescriptiveandInferentialStatistics. Results:In one group, pre test mean score was 5.75 with S.D 2.48 and in post test mean score was 3.22 with S.D 1.44. The calculated t value of 9.26 shows statistical high significant difference in the low back pain at p&lt;0.001 level between the one group pre test and post test. Low back pain had shown statistically significant association with the gender, BMI, working hours a day. And other demographic and clinical variables were not shown any statistically significant in one group pre test and post test. Conclusion: Thereby the researcher had demonstrated and educated the staff nurses who were working in Critical care unit and Operation Theater by maintain proper comprehensive body mechanics in minimizing the level of low back pain.

Massive Haemo Thorax Following Ultrasound-Guided Central Venous Catheterization in an Anaesthetized Patient: A Case Report

Central venous catheterization is a commonly performed procedure in operation theatre. After the advent of ultrasound (US) guided central venous catheterization (CVC), the incidence of life-threatening complications has reduced significantly and are rare. We present a case of haemothorax in a young patient after US guided, which was inserted at the end of surgery under anaesthesia. The operator had some technical difficulty while inserting the CVC. The Haemothorax was diagnosed post-operatively in the ward after was missed clinically by radiological investigation. It was treated by inserting a 36 Fr chest drain on the second post-operative day which was removed on the seventh postoperative day and the patient was discharged to home.

Longitudinal Parallel Compression Suture To Control PPH Due to Placenta Previa &amp; Accreta.

Objective: To determine the efficacy and safety of longitudinal parallel compression sutures to control postpartum haemorrhage (PPH) in placenta previa/accreta patients. Methodology: This cross-sectional study was conducted at Department of obstetrics and gynaecology, Peoples University of Medical &amp; Health Sciences for Women; Nawab shah for a period of six months from 7th June 2023 to 6th Dec 2023, after getting approval from ERB of People University of Medical &amp; Health Science. Sample size achieved through non-probability consecutive sampling. Women fulfilling inclusion criteria were selected from the operation theatre of Obstetrics &amp; Gynaecology, PUMHS Nawabshah. To control life threatening PPH owing to placenta previa (with or without accreta) during caesarean section, longitudinal parallel compression sutures in operating room. Outcome variables observed includes amount of blood loss, number of days stayed in the hospital, need for concurrent procedure, need of hysterectomy, and maternal death. Data was entered and analysed on SPSS 25. Results: The stitch was applied in 31 patients. The technique was effective, and successful as a single procedure in 11 patients (35.43%). 6 patients (19%) needed additional tamponade; 12 patients (38%) also received concurrent uterine artery ligation while 2 needed ovarian artery ligation. Despite concurrent procedure 3 patients ended up for hysterectomy (9.1%). The most common indication of caesarean section was placenta previa (51%), mostly done at a gestational age of 37 weeks ± 1.84 standard deviation. Mean age of the patient was 29 years. Estimated blood loss was more than 1.5 litre as seen in 22.6% of the patients and 71.6% patients need blood transfusion. Uterine atony was a common cause of PPH (51%). 51.6% of patients discharged within 3 days of surgery. Two patients expired. Conclusion: The innovative suture techniques have shown promise in improving surgical outcomes in resource-constrained environments, especially in developing countries. This effectiveness can help bridge the gap between limited resources and the need for quality surgical care. Key words: PPH, Uterine Compression Suture, Placenta Previa, Placenta Accreta.

Commencement and Monitoring: Microbiological Surveillance in Operation Theaters at a Tertiary Care Center in North India

Commencement and Monitoring: Microbiological Surveillance in Operation Theaters at a Tertiary Care Center in North India

Assessing the Anaesthetic Time on Operation Theatre Utilisation and Case Cancellation

The time to perform an anaesthesia-related procedure at induction and emergence is often overlooked as part of the operation theatre (OT) utilisation time. This prospective observational study aimed to assess the estimation done by the surgeons and anaesthetists on anaesthesia times and the overall OT utilisation in our centre. This prospective observational study included elective cases from 13 surgical disciplines. The trainees, specialists and consultants from surgical and anaesthesia teams estimated the anaesthesia times separately before the surgical procedures. The actual anaesthesia, surgical, total procedural and turnover durations taken to complete the cases were documented. Operation theatre utilisations of those various surgical disciplines involved in the study were also analysed. We analysed 128 elective cases. The average mean time spent for anaesthesia procedures was 28.4 ± 14.1 min, with the mean induction time was 16.0 ± 9.8 min and the mean emergence time was 12.5 ± 8.6 min. Both anaesthetists and surgeons overestimated the anaesthetic times, but anaesthetists estimated closer to the actual anaesthetic times (r = 0.64 vs r = 0.49, respectively). There was no significant difference in the estimated anaesthetic times between different experience levels. All the surgical disciplines had average OT utilisation exceeding 90%, indicating overutilisation. A total of 12 cases (7.1%) were cancelled. Most cases were cancelled due to exceeded allocated block OT times (7 cases) or unavailability of ICU beds (2 cases). We concluded that OTs exceeding the given OT time is the most frequent reason for cancelling elective surgical cases on the day of surgery.

Enhancing Team Performance in Surgical Operations: A Case Study at a Private Cancer Hospital and Research Centre in Thrissur District

Purpose: The purpose of this study is to evaluate the existing team dynamics within the surgical crew; to gain insights into the perceptions of different team members regarding team effectiveness and potential areas for improvement; to investigate factors crucial to successful teamwork in the operation theatre, and to analyze successful practices that have positively impacted team performance and patient outcomes. Design/methodology/approach: Quantitative data was gathered through a validated questionnaire distributed among surgical team members at a private cancer hospital and research center in Thrissur District, Kerala. Descriptive research was adapted for this study. The population for the study includes the members of the surgical team. A sample size of 120 members including doctors, nurses, technicians, and other supportive members who participated in various surgeries, were selected using a random sampling technique for the data purpose. Findings: The findings of the study disclosed that the challenges included occasional communication breakdowns and role ambiguity that seriously influenced the team performance of a surgical crew. Successful practices involved structured communication protocols, regular team training, and a collaborative leadership approach. Stakeholders accentuated the need for continuous improvement in strategies premeditated to the operation theatre’s unique demands. Research limitations/implications: The study’s inferences underscore the necessity for targeted intermediations focusing on the factors manipulating the surgical teams. Implementing structured training programs, refining communication protocols, and fostering a collaborative leadership culture can notably improve team performance. Additionally, modifying these interventions to suit the specific demands of the operation theatre is essential for sustaining and augmenting positive changes in teamwork dynamics, ultimately elevating the quality of patient care and outcomes. Social Implications: The empirical research contributed to enhancing the quality of surgical care, improving patient safety, and refining the overall performance of surgical teams in specialized healthcare settings through enhanced team performance for societal well-being by improving patient outcomes and reducing healthcare disparities. A more cohesive surgical team fosters a safer environment, positively impacting patient satisfaction, trust in healthcare, and overall community health. Additionally, it promotes a culture of collaboration and excellence, setting a precedent for improved healthcare practices within society. Originality / Value: The originality of the study lies in its broad examination of team dynamics within a specialized setting, the operation theatre of a private cancer hospital, and a research center. The study offers insights into specific challenges, successful practices, and context-specific interventions, to enhance team performance and patient care in this distinct healthcare environment.

Occupational hazards and pregnancy in orthopaedics: female surgeons are at increased risk of infertility and pregnancy complications.

Female surgeons have increased rates of infertility and pregnancy complications compared to the general population. Reported infertility rates in surgeons are 32% compared to 10.9% in the general population. Reported pregnancy complication rates in surgeons range from 25% to 35%. In the orthopaedic operating theatre occupational hazards that have an effect on pregnancy outcomes include radiation, exposure to methyl methacrylate in bone cement, surgical smoke, sharps injuries, exposure to anaesthetic waste gases and the effects of the physical demands of surgery including prolonged work hours and night shift work. Outside the operating theatre exposure to nitrous oxide, formaldehyde, surgical scrub also have evidence of negative pregnancy outcomes. This review summarizes the available evidence as it relates to specific occupational hazards that face health workers in an orthopaedic operating theatre. This information, while targeted at orthopaedic health workers, is also relevant to anaesthetists, radiographers, nursing staff, medical device company representatives and female surgeons in other specialties.

EFFECTIVENESS OF DOUBLE-GLOVING METHOD ON PREVENTION OF SURGICAL GLOVE PERFORATIONS AND BLOOD CONTAMINATION: A PROSPECTIVE STUDY

Objectives: To evaluate efficacy of double gloving to provide mechanical barrier against communicable diseases and also to evaluate different parameters affecting glove perforation rate. Methods: This prospective study was performed in department of General Surgery at tertiary care teaching hospital of Gujarat. This study involved a group of surgeons and operation theatre nursing staff. Randomization of the participants was done with the closed envelope method in two groups: single gloving and double gloving. Glove perforation rate and hand contamination rate was calculated and compared between both the groups. Participants of double gloving groups were also asked for discomfort using double gloves and compromised tactile sensations. Results: There was no statistically significant difference in the glove perforation rate between single gloves and double outer gloves. (p=0.55) But, the glove perforation rate was significantly low in double inner gloves than single gloves. (p=0.004) The hand contamination rate was significantly lower amongst perforated double gloves than perforated single gloves. (p=0.00001) Awareness of glove perforation was absent in majority of the participants in both the groups. All the participants in the double gloving group were comfortable with using double gloves and their tactile sensations were not compromised. Conclusion: This study concluded that double gloving efficiently prevented hand contaminations during a surgery. There was no significant difference noted in glove perforation rates in both single and double gloving groups. Double gloving is recommended for the surgeons and nursing staff to protect them from blood borne infections and eliminate the chances of surgical site infections in the patients.

A Comparative Study to Assess the Level of Stress among Nursing Staff of Private Hospital's Operation Theatre and Government Hospital Operation Theatre in Aurangabad

A Comparative Study to Assess the Level of Stress among Nursing Staff of Private Hospital's Operation Theatre and Government Hospital Operation Theatre in Aurangabad

Peri-partum Thrombotic thrombocytopenic purpura - A 29 years old pregnant lady presented with convulsion and thrombocytopenia

Thrombotic thrombocytopenic purpura associated with pregnancy is a rare antibody‐mediated thrombotic microangiopathy with high maternal and fetal mortality. We present a 29-year-old Bangladeshi pregnant lady of 32 weeks of gestation who presented to a tertiary care hospital with multiples episodes of generalized convulsion. She was immediately transferred to the operation theatre and after delivery of her baby, she was transferred to ICU. Her reports revealed features of hemolytic anemia, thrombocytopenia and renal failure. She was suspected as a case of Thrombotic thrombocytopenic purpura and received therapeutic plasma exchange. Her condition gradually improved and she was discharged to home in stable condition. Bangladesh Crit Care J March 2024; 12 (1): 68-71

A retrospective study about cancellation of elective surgeries in a tertiary care hospital

Abstract Introduction: Operation theaters (OTs) are one among the core functionalities in a health care institution that require a considerable amount of 5 Ms—man, machine, money, material, and management. Any idle time or underutilization in the OT creates a huge loss of these resources and is also inconvenient to patients and those on the waiting list. Thus, a planned and well-conceived operational method has to be followed to reduce the cancelations of scheduled cases and to optimally utilize the OTs so that they become more efficient. This study has been done to understand the basic reasons for the cancelation of elective surgeries at a tertiary care hospital and to effectively tackle them by suggesting suitable solutions to overcome these challenges. Objectives: Primarily, to understand the reasons for the cancelation of surgeries in OTs, and secondarily, to put forward suggestions for optimal usage of OTs. Materials and Methods: This was a retrospective study, with Pareto analysis and root cause analysis (RCA) as the tools. Records were obtained from the Central Scheduling Department of the Hospital between January 2020 and November 2022 (35 months). Results: During the study period, 53,177 surgeries were performed in the main OTs. There were 2289 (4.3%) cancelations. Nearly 84% of canceled surgeries were canceled within 24 h. Cancelations were 63% in males and 37% in females. Seventy-nine percent were of Indian nationality, and the rest were of various nationalities. Conclusion: The reasons for the cancelation of elective surgeries were multifactorial. Controlling these, and thus preventing cancelations, is imperative in the effective functioning of the institution as a whole. We recommend thorough evaluation, early preanesthetic checkup (PAC) and well-planned scheduling without haste as some of the measures to reduce the chances of cancelation.