News archive - July 2018
Modern lighting helps surgeons see the way
Lighting is crucial in healthcare environments, enabling accurate diagnoses and enhancing the healing and working environment.
But good lighting is perhaps most critical in operating theatres, where the ability to see the smallest detail can make all the difference to outcomes.
Graeme Hall of lighting manufacturer, Brandon Medical, explains: “Lighting is a crucial part of any operating theatre environment; providing the necessary lighting conditions for surgeons to perform life-changing procedures.
“Despite the huge advances in surgery, the fundamental requirement remains the ability to see what you’re doing.”
Lighting specification is covered in the guidance document, HBN 26: Facilities for surgical procedures; by the design standard, EN 12464; and in the Chartered Institution of Building Services Engineers’ (CIBSE) Lighting Guide 2: Hospitals and health care buildings.
It was also the subject of a buyer’s guide published in 2010 by the NHS Purchasing and Supply Agency’s Centre for Evidence Based Purchasing following comments from The Royal College of Surgeons of England which indicated that lighting within operating theatres was an area of concern.
The document states: “Effective and successful performance within the operating theatre is enhanced by having lighting which does not cause visual, operational, and environmental difficulties such as glare, shadowing, or visual stress.
“Incorrect or poor lighting can impact on the patient through poor performance and impaired effectiveness, which may cause lengthened procedures through uncertainty or even errors.
“The wellbeing of the surgeon, the anaesthetist, and surgical team may also be adversely affected, while the quality and safety of the working environment will be impaired by poor ambient lighting.”
With many theatres traditionally used for open surgery now also being employed for keyhole, laparoscopic, endoscopic or minimally-invasive procedures, the key is lighting that is multi-functional and can be easily adjusted.
And modern LED luminaires are helping to provide the solution.
Brandon Medical has achieved a breakthrough in this technology with its High Definition LED (HD-LED).
It solves the fundamental problems of poor colour rendition and thermal management that can inhibit traditional LEDs from being used in surgical settings.
“LED lighting is a very energy-efficient lighting technology; but HD-LED takes it a step further,” said Hall.
“It can reduce the energy consumed for lighting by over 80%; and, as 20% of all energy use is for lighting; HD-LED can reduce the energy consumption of a building by 16%.”
Brandon is also seeing increased interest in its Quasar lighting solution, another innovation designed in response to comments by, and feedback from, surgeons.
It has been installed in operating theatres at hospitals around the globe, including the world-famous Great Ormond Street Children’s Hospital in London.
Hall said: “When considering a theatre lighting solution, the main things to think about are colour rendition; quality of movement and handling; width of light beam; comfort Halo; and, last but not least, infection control.
“After studying countless procedures and conducting interviews with clinical staff, we observed that surgeons work on red tissue and we know the human eye is weakest in the red part of the spectrum.
“Quasar is the first operating light with extremely-high colour rendition across the full visible spectrum, making it much easier to see even small differences in tissue.
“Red light content is optimised for perfect visualisation of red tissue and to overcome poor eye-sensitivity. And users can adjust the red balance to match their own colour perception and highlight differences in tissues.”
This adjustability is crucial in modern solutions, and was the main driver behind the design of Dräger Medical UK’s Polaris 600 OR Light.
Project specialist, Sarah Sanderson, said: “You can’t operate without light, but the quality of light is paramount to the surgical procedure.”
Both companies have also seen increased interest in lighting systems with integrated cameras, which enable surgeons to use the most-up-to-date instruments.
A major advancement
Sanderson said: “LED was a major advancement for surgical lighting in terms of the lifespan, quality and running costs. Other technologies such as the Wireless Camera facility are also increasingly popular, enabling quick and easy upgrade to add camera modules to existing light heads, safely positioned behind the glass.”
Hall added: “Beyond the primary purpose of lighting, surgeons require more a secondary, but essential function and feature, which is the ability to have integrated cameras.”
Cost of ownership is another critical consideration, and specifiers and manufacturers need to consider a range of issues as the health service struggles against ongoing cuts to its budget.
When choosing a lighting solution, daily running costs must be factored in, alongside the cost of consumables, maintenance, and serviceable parts.
The CIBSE lighting guide states: “Often, clinical preference will influence the features of lights required, based on the positive characteristics or limitations of existing lights.”
And it states that decisions should involve surgeons, nurses, biomedical engineers, architects and lighting engineers and the operating theatre committee.