New technical solution to minimise noise exposure for surgical staff: the ‘silent operating theatre optimisation system’

Abstract

The increasing number of technical equipment in the operating room (OR) is resulting in significantly higher noise levels. The more complex and sophisticated the surgical procedure is, the more essential it is for all team members of the OR to work together in a harmonious fashion to process and manage their demanding team tasks. With increasing noise in OR, the risk of more frequent errors also increases. The reduction of noise production in the OR is possible but limited. The aim of this study was to develop a device that reduces ambient noise for the operating team without hindering their ability to communicate.We developed a new communication technology set-up for the OR to meet all needed requirements. All members of the operating team are issued headsets with microphones. The headsets filter out background noises (active and passive noise cancelling) and the microphones enable interactive communication among and between OR subgroups through targeted information selection (signal selection). Any remaining background noise is overshadowed by music, which is quiesced by direct speech into the microphone (ducking). Information flow is programmed on a digital workstation, providing each team member a selection of acoustic signals from the OR on their bidirectional headset. A complex matrix of connections in this audio technology allows a predefined communication structure. These procedures were assembled in the Silent Operating Theatre Optimisation System (SOTOS). The technical specifications and user interface are described. A pilot study in 2015 using the SOTOS in cardiac surgery showed very positive feedback from the participating operating team members. Further studies focusing on communicational psychology perspective and physiological reaction are recommended.

The Silent Operation Theatre Optimisation System (SOTOS©) to reduce noise pollution during da Vinci robot-assisted laparoscopic radical prostatectomy

“…Further studies to investigate the reasons of the different acceptance of the system within the surgical team focusing on communication structure and technical benefits should be planned. Friedrich et al could show that SOTOS © reduces questions and general communication during the surgery [21]. Bypassing the distance between surgeon and the rest of the team in the da Vinci OR could explain a subjective improvement for the surgeon and the team through SOTOS © .…”

“…Previous studies showed a negative effect of noise in the OR for the whole surgical team [ 3 – 5 ]. Friedrich et al developed SOTOS © and were the first to show this new technical device to minimize noise exposure for cardiac surgery teams [ 21 ]. SOTOS © comprises not just noise reduction, but also shields disturbing environmental noise and offers immediate and direct voice information by the individual hearing.…”

“…Setting and development was previously described by Friedrich et al [21]. The communication system SOTOS © was installed in a standardized way for each surgery.…”

“…With regard to the potential risks of noise especially on health of surgical teams, noise and information overload in high-tech environments like with a surgical robot and the positive influence of music Friedrich et al developed the "Silent Operating Theatre Optimisation System (SOTOS © )" [21]. SOTOS © is a complex communication tool developed for the usage in the OR [21]. This technical solution allows the surgical team to communicate via headphones for noise reduction and microphones for interactive communication.…”

“…The so-called "noise gate" opens the microphone for speech up to a certain noise level and closes it automatically. Additionally music can be played individually for each team member [21]. The music played is interrupted through speech.…”