Operating Room Green Lights: Why ORs Dim or Tint Light for Laparoscopy

The problem: a bright room and a dim endoscopic image

During laparoscopy the surgeon works from a monitor. The image on that screen has limited contrast, and bright ceiling light reflects from the glass, washes out dark areas and makes the eyes adapt back and forth between a bright room and a darker screen. Many teams therefore reduce the surgical lights and room lights, but total darkness is unsafe: nurses must see instruments, counts, the patient and the floor.

The compromise is a low, controlled ambient level that keeps the room readable without competing with the screen. Where the surgical light is still needed, for example for a conversion to open surgery or for a port site, it should be dimmable to a low level without changing its colour.

Why green or tinted light is sometimes used

Some theatres use green or blue-green background light. The commonly cited reasons are that these colours are comfortable at low brightness, do not compete with the red-dominant endoscopic picture, and reduce the visual after-image that follows long periods of looking at red tissue. Green and blue-green are also traditional scrub colours for a similar reason.

There is no single standard for ambient colour in laparoscopy, and practice differs by hospital and surgeon. Treat green lighting as a room design choice to be agreed with surgeons and nurses, not as a requirement. Do not rely on it to replace adequate task light for staff who need to read labels or observe the patient.

How endoscopy mode works in a surgical light

An endoscopy mode lowers the output of the light head to a comfortable level, sometimes with a fixed colour temperature, so the team keeps a soft light on the field and the room. The SIMEON HighLine Sim.LED 8000 has a dimmable endoscopy light called Sim.BIANCE, in addition to its main dimming range of 48,000 to 160,000 lx.

Q-Flow surgical lights provide integrated dimming from 10 to 100 percent, which lets the team reduce the light for endoscopic work. Check with your supplier exactly how each model behaves, since not all lights have a separate endoscopy function. Our Q-Flow overview shows how the versions differ.

Planning room lighting for laparoscopic and hybrid work

Plan a scene-based lighting system rather than a single switch. Typical scenes are open surgery, laparoscopy, preparation and cleaning, each with its own level for ceiling lights, wall washers and the surgical light. Place dimmable fixtures so that no source reflects in the monitors, and position monitors to avoid glare from the lights.

If you have a video-integrated OR, scenes can be linked to the integration system. Lojer's OpenOR can control room functions such as lighting from the same interface as video, which is useful for one-touch laparoscopy scenes. See also our summary of operating room lighting requirements.

What to ask a supplier

Ask whether the surgical light has a dedicated endoscopy mode, its minimum light level, whether colour temperature changes when dimming, and whether it can be set from the sterile handle or a wall panel. Ask also whether presets can be stored for each surgeon.

Document the agreed lighting scenes in the OR protocol so that every shift sets up the room in the same way, and review them with the surgeons after the first weeks of use.

Beckfinity's team can help you compare SIMEON and Lojer surgical lights for laparoscopic theatres and arrange a demonstration; request a consultation through our contact page.