New surgical luminaires – More than just lighting – Medical Buyer

Integrating advanced technologies promises to revolutionize operating room environment further, setting new standards for safety, efficiency, and clinical excellence.

In the 1920s, French professor Weyland invented the world’s first OT light for surgery in England. Whelan placed a 100-Watt bulb at the center of the refractive lens, formed by evenly spaced narrow plate glasses on the dome of the operating lamp, creating a cone-shaped OT light without a spire.

The second reform of operation theater lighting was France’s single-dome-type ceiling OT light and the United States track-type surgical OT light in the 1930s and 1940s.

By the 1950s, to improve the illumination of hospital OT lights, the hole-type multi-lamp operation light was produced and used in Europe and Japan, one after another. It increased the number of light sources and used a small reflector made of high-purity aluminum to improve the lighting performance of hospital OT lights.

However, due to the increase in the number of light bulbs, this type of OT light caused a rapid temperature rise, predisposing doctors to discomfort and dry tissue at the surgery site, which was detrimental to the patient’s post-operative recovery.

In the early 1980s, Japan started producing cold-light hole-type surgical shadow-less lamps using halogen light sources. In the late 1980s and early 1990s, overall reflection halogen OT light came out, using computer-aided design (CAD) techniques to create the reflector surface, formed by industrial stamping at a time, which formed multilateral reflectors; this surgical light source was not only as bright as daylight but also had a good shadow-free effect.

As we enter the 21st century, the details of the operation theater light continue to be refined. In addition to improved basic performance parameters, such as illumination, shadow-less effect, color temperature, and color rendering index, strict requirements for uniformity of illumination are also present. With the application of LED light sources in the medical industry, new opportunities have also been presented for developing surgical OT light.

In recent years, LED OT lights have slowly dominated the market, with features such as excellent cooling effect, good light quality, unlimited brightness regulation, uniform lighting, no screen flash, long life, energy saving, and environmental protection.

Hospital lighting is vital to healthcare facility design, impacting patients’ and medical professionals’ physical, emotional, and psychological well-being. From patient rooms to surgical suites, hospital lighting design requires a holistic approach that considers factors such as circadian rhythms, infection control, energy efficiency, and the overall healing environment.

Lighting directly influences patient well-being. In patient rooms and common areas, natural light from windows, skylights, and strategic bed placement promotes circadian rhythm regulation and aids healing.

Global marketThe global market for OT lights is expected to witness significant growth in the coming years. The market is estimated to be USD 674.4 million in 2022, growing at a CAGR of 4.9 percent.

Integrating advanced technologies, such as artificial intelligence (AI), to develop innovative surgical light products is supporting revenue growth. Moreover, the crucial equipment used in hospital operating rooms and surgery centers provides superior illumination for medical procedures, including emergency rooms, labor and delivery spaces, and examination rooms, another major factor driving demand for surgical lights.

In addition, the increasing sales of LED lights are also boosting revenue growth.

Also, technological advancements in manufacturing more advanced surgical lights are increasing adoption, thereby driving the market’s revenue growth. In addition, growth in regulatory approvals for different surgical lights boosts market revenue growth.

Increasing product availability, rising demand for well-equipped surgical lights to improve and enhance the visibility and accessibility of healthcare facilities, and improving healthcare infrastructure in emerging countries are key factors boosting the revenue growth of the global surgical lights market.

Fundamental principles of modern operating lights

Vikas KhannaSouth Asia Head/Director,Brandon MedicalEssential features. Operating lights are designed to provide optimal illumination for surgeries, focusing on minimal shadows, reduced heat, and accurate color rendering for extended use without discomfort.

Light intensity. Light intensity at 1 meter from the lamp head is a standard measurement for operating lamps. While high intensity is essential, ensuring the correct light color is even more critical.

Color accuracy. For adequate surgical illumination, operating lamps must provide a well-balanced mix of light in the red and yellow frequency ranges, as surgeons often work with red and yellow tissues. Proper color balance ensures that all objects, including non-red and yellow, are visible; ideal operating light mimics the color of morning daylight.

Cold light. Cold light involves visible light with infrared content removed to prevent tissue heating. Effective lamps filter out infrared and ultraviolet light, using high-performance sources and coatings.

Shadowless illumination. Multiple beams from different angles reduce shadows, caused by obstructions, ensuring uniform illumination. Multiple lamp heads can enhance this effect.

Uniform light. Uniform illumination prevents eye strain. High-quality lamps maintain consistent light intensity across the field, measured by the beam uniformity ratio (d50/d10).

Deep cavity penetration. As international standards define, lights must illuminate deep cavities, ensuring sufficient light reaches the surgical site.

Adjustable focus and depth of field. Lamps with adjustable fields allow surgeons to change the diameter and intensity of light as needed, using multiple reflector systems.

Hygienic design. Easy-to-clean designs, without ventilation slots or dirt traps, prevent contamination. Sealed designs are preferred to avoid harboring germs.

Laminar flow compatibility. Operating lamps should not interfere with laminar flow systems used to maintain ultra-clean environments. Designs that minimize disruption to airflow and dissipate heat evenly are essential.

LED life and efficiency. High-performance LED light sources are crucial for minimizing downtime. Proper optical system design ensures maximum performance and longevity.

Camera integration. Video cameras are increasingly used in operating theaters, often integrated into the lamp head for convenience and optimal positioning. This integration allows for seamless recording and viewing of surgical procedures.

By adhering to these principles, modern operating lights provide the essential illumination for successful surgical outcomes.

The OT lights market, however, faces challenges, such as the higher costs associated with surgical lights, which are one-factor restraining market revenue growth.

Based on type, LED lights dominate the market, offering high-intensity illumination and precise focusing capabilities crucial for surgical procedures. LED technology’s lower heat emission reduces tissue injury risk and improves comfort. LED lights’ durability minimizes replacement needs, leading to cost savings and enhanced visibility, precision, and safety in surgical settings. From superior illumination quality and adjustable color temperature to shadow reduction and energy efficiency, these innovative lighting solutions continue to elevate the standard of care in operating rooms worldwide.

Hospitals are significant end-users of surgical lighting systems, employing them in operating rooms, emergency rooms, and intensive care units for surgeries. These systems are crucial for providing optimal illumination, ensuring accurate diagnosis, and facilitating safe and efficient procedures across various surgical specialties, contributing significantly to their growth.

Regional insights. North America accounts for a leading position in the global business due to the high volume of surgical procedures, well-equipped healthcare facilities, and a strong focus on patient safety and surgical precision in the region. Moreover, the presence of major healthcare companies and manufacturers also contributes to the significant market opportunities in the area.

Europe is known for its robust healthcare systems, advanced medical research, and strong regulatory frameworks.

Asia-Pacific is expected to register the fastest market CAGR owing to the increased spending power of consumers. The rising number of government initiatives aimed at healthcare sector enhancement and the strategic expansion of prominent manufacturers into emerging markets are key drivers boosting revenue growth of the surgical lights market in the region. Countries in Asia-Pacific, including India, with their sizable populations, are registering a rise in demand for healthcare infrastructure.

This can be attributed to increased hospital numbers, healthcare reforms, and advancements in medical technology, which, in turn, contribute significantly to the market’s revenue growth.

Chromatic performance index – why is this indicator important?The color rendering index (CRI) is a critical metric in lighting design. It represents how healthy a light source renders colors compared to a natural reference light. Administered by the International Commission on Illumination (CIE), CRI is the only internationally accepted standard for measuring color-rendering quality. It assesses the color appearance of 14 reflective samples from the standard Munsell range under a test light source and a reference light.

CRI is crucial in various lighting applications. High CRI values are fundamental in settings where color accuracy is vital, such as healthcare, art studios, and retail. LED lighting is a popular choice due to its ability to provide a high CRI, closely resembling natural sunlight, thereby improving the accuracy of tasks requiring color discrimination.

Despite its widespread use, CRI has several limitations. The CIE CRI calculation needs to be updated, and only eight of the 14 reflective samples, all of which have low to medium chromatic saturation, should be considered. While lamps with a high CRI may render these colors well, they can perform poorly on more saturated colors. For example, typical 80 CRI LEDs often have inadequate red performance, resulting in poor rendering of objects containing red pigments, such as hemoglobin in human skin. Therefore, the R9 index, representing a saturated red color, is often listed separately in color-critical applications.

Moreover, the arithmetic averaging values can mask poor rendering of specific colors. Additionally, CRI only evaluates color fidelity, ignoring other important aspects such as chromatic discrimination and observer preferences. Chromatic discrimination refers to the ability to distinguish between similar colors, while observer preferences relate to how pleasing a light source makes colors appear.

To address these deficiencies, new color-rendering metrics have been developed. These include TM-30-18, color quality scale (CQS), gamut area index (GAI), and others. These metrics aim to provide a more comprehensive evaluation of color rendering, considering various factors beyond simple fidelity.

While CRI remains a vital indicator of color rendering quality, understanding its limitations and developing new metrics are essential for advancing lighting technology and ensuring the highest color accuracy and visual comfort standards.

Integration with surgical equipment in OT lightsModern surgical lights are designed for seamless integration with other surgical equipment and systems, such as surgical cameras, video displays, and digital documentation devices. These integrated systems enhance the overall surgical workflow and facilitate advanced visualization and recording capabilities. These integrated systems are essential for operating rooms, providing optimal illumination during surgical procedures.

Surgical light systems provide bright, shadow-free illumination, enabling surgeons to perform procedures with precision and accuracy. They often consist of multiple light sources, such as LED or halogen bulbs, arranged in a specific configuration to achieve uniform lighting across the surgical area.

Surgical light manufacturers often offer an integrated high-resolution camera. This camera records procedures for training and quality assurance purposes and provides a live feed to the medical team within the operating theater. Using a Wi-Fi-enabled camera does not add to the complex cabling system within an operating theater. An IP camera uses its IP address to connect to a network, eliminating the need to connect to a PC or alternative host device. These cameras can be easily added to an existing network, and many functions can be controlled over the IP connection.

Integrating surgical lights with other surgical equipment improves efficiency and effectiveness in the operating room, supporting surgeons with advanced tools and capabilities for better surgical outcomes.

In cellular grafting techniques for stable vitiligo, specifically in the non-cultured epidermal cell suspension (NCES) procedure, OT lights are used in an innovative manner. Traditionally, an incubator is used to trypsinize the harvested graft at 37oC for 30–120 minutes. However, incubators are costly, occupy significant space, and can disrupt the procedure, if they malfunction.

The proposed solution leverages the heat generated by OT lights, mainly LED lights, as an alternative to incubators. After harvesting the skin graft, it is placed in a trypsin-ethylenediaminetetraacetic acid solution within a tube and taped to the patient’s skin near the surgical site under the OT light. As the surgeon works on dermabrasion, the heat from the OT light incubates the graft. Although LED lights are efficient, they still generate heat, which can be utilized to maintain the required 37oC for trypsinization.

This innovation eliminates the need for costly, space-occupying incubators by utilizing the OT light’s heat. This makes the procedure more accessible and efficient, especially in low-resource settings. It also avoids the inconvenience of prolonged waiting periods or uncomfortable alternative methods. The OT light thus serves a dual purpose, providing illumination and necessary heat, making the cellular grafting procedure more feasible and cost-effective.

A timeline of surgical lighting – Is automated lighting the future?As technology in medicine and surgery has advanced, so has the potential for surgical lighting innovations.

Automated lighting (AL) integrates established technical approaches, such as AI, 3D sensor tracking algorithms, and thermal imaging, to enhance surgical precision and efficiency.

While AL holds immense promise, further focused research is essential to maximize its effectiveness and integrate this advanced technology into modern operating rooms. The potential of AL has evolved significantly alongside technological advancements in medicine and surgery, offering new possibilities for enhanced surgical outcomes.

Current forms of surgical lighting have been rigorously evaluated, highlighting their strengths and weaknesses. Despite their reliability, concerns persist regarding safety and economic efficiency, prompting the need for optimization in clinical settings.

AL emerges as a transformative application poised to revolutionize the operating room environment. AL represents a significant advancement over traditional lighting systems by addressing critical issues such as safety, efficiency, and precision. Future research efforts should prioritize refining technical approaches and conducting robust experimental studies to validate AL’s efficacy in real-world surgical settings.

Challenges associated with contamination, eye strain, and surgical burns remain essential considerations for novel lighting technologies. While imperfect, the compelling evidence suggests that AL holds the potential to define the future of surgical lighting, paving the way for safer, more efficient, and technologically advanced operating rooms.

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