By Don Sadler
Technology and safety go hand-in-hand in today’s operating rooms and ambulatory surgery centers. A wide range of technological advances are making surgery safer for patients and practitioners than at any time since the advent of modern surgery.
“The most important new technologies in the operating room are those that help teams see, understand and manage what is happening in real time,” says Robert Brown, co-founder, president and CTO of OMNIMED SmartOR. “This includes AI-driven workflow and situational awareness tools, imaging and telemetry systems, robotic-enabled assistance and performance analytics platforms.”
OMNIMED SmartOR is an AI-enabled platform that integrates real-time data and performance analytics into surgical environments. “It captures more than nine million data points per minute in real time and turns them into clear safety and performance insights for clinical teams and hospital leadership,” says Brown.
Managing Awareness During Cases
Similar to a car dashboard, SmartOR provides an intraoperative view that helps perioperative teams manage awareness, timing, turnover and response during the case. “After the case, SmartOR’s agentic AI tools support review, discovery and digital twin modeling so teams can improve workflows and outcomes over time,” says Brown.
In December, plans were announced for the nation’s first AI-powered Smart Surgical Performance Center at The University of Maryland, Baltimore, to be powered by OMNIMED SmartOR.
“Within the Smart Surgical Performance Center, SmartOR will also connect the classroom, skills lab and operating room for the first time,” says Brown. “This will create a feedback loop that helps hospitals understand how training and skills translate to real-world performance, thus improving safety, teamwork and overall surgical value.”
According to Brown, new technologies like OMNIMED SmartOR improve safety by helping perioperative teams detect risks, trends and performance issues that aren’t visible through observation alone. “The operating room is the most data-rich area of the hospital, and agentic AI now helps turn that data into useful insight,” he says. “This reduces complications, delays, cancellations and financial loss.”
Brown stresses that AI tools don’t make decisions or replace clinicians. “They give perioperative professionals better information so teams can improve outcomes, reduce cost and risk, and strengthen both safety and the business performance of surgery,” he says. “All information is treated as quality-improvement data under peer-review protection and is used for learning and improvement, not for punishment. This encourages a safer and higher-performing culture.”
Zach Swartz, perioperative practice specialist, nursing practice with the Association of periOperative Registered Nurses (AORN), lists a number of different ways that AI-enabled technology is improving patient safety. These include assessing and identifying high-risk perioperative patients pre-operatively, monitoring patients during procedures, as clinical decision support to aid in making care decisions, and for discharge planning and education.
“Additionally, extended reality (XR) technology, which encompasses augmented reality and virtual reality, is being incorporated into surgical training, intraoperative navigation and post-operative wound assessment,” says Swartz.
“These technologies show promise in aiding perioperative team members with enhanced patient care delivery while reducing strain and burdensome workflows when they incorporate user-centered design principles,” says Swartz. “Integrating them into the clinical care setting requires a thorough evaluation and assessment of the potential advantages and disadvantages.”
Technology to Evacuate Surgical Smoke
The health hazards of surgical smoke have been well-documented for decades. The U.S. Occupational Safety and Health Administration (OSHA) first issued an alert about these health hazards in 1988.
Numerous studies confirm that surgical smoke contains hazardous chemicals, bacteria and live viruses. “Toluene, benzene and formaldehyde are compounds that can get into the gas exchange regions of the lungs and trigger adverse outcomes,” says Brenda C. Ulmer, RN, MN, CNOR. “In fact, benzene is a known trigger for leukemia.”
Smoke evacuation technology is the most effective way to eliminate surgical smoke in the OR. “This technology is designed to ‘clean up’ the air and reduce the ever-present danger of breathing volatile organic compounds contained in the smoke,” Ulmer explains.
Smoke evacuators incorporate ultra-high-efficiency filters to remove smoke particles from the suctioned airstream at the surgical site. They use high flows to capture smoke at the nozzle, draw it through the tubing, pass it through the filters and recirculate to room air.
While smoke evacuation technology has been available for years, standardized adoption has been lagging. The good news is that the drive to get surgical smoke evacuation legislation passed in more states is picking up steam. According to Ulmer, 20 states have now enacted legislation requiring the evacuation of smoke from the operating room.
“It’s a hard battle going state-by-state seeking safe OR workplaces, but it’s worth the effort to protect the health of current and future generations of perioperative professionals and patients,” says Ulmer. “The most important thing we can do now is stay the course. What we have done so far with legislation has worked better than previous endeavors.”
Swartz says there are several different smoke evacuation devices available on the market. “AORN doesn’t endorse one specific product,” he says. “Instead, AORN recommends that perioperative teams evacuate and filter all surgical smoke by positioning the smoke capture device as close to the site of creation as possible to capture the maximum amount of surgical smoke.”
Swartz is also bullish about technology that aids in the detection and localization of retained surgical items. “These adjunct technology devices are used to detect surgical softs goods such as sponges and surgical instruments,” he says. “They utilize different types of technology, including radio-frequency (RF) detection and radio-frequency identification (RFID).”
When used correctly, these devices have been reported to prevent up to 97 percent of all incidents of unintentionally retained surgical items. Swartz stresses that they should be used as a supplemental measure after completing the manual counting process to verify the outcome of the surgical count.
Hypodermic Needlestick Injuries
It has been more than two decades since the Federal Needlestick Safety and Prevention Act of 2000 was passed, but sharps injuries remain a problem in the perioperative setting. Hypodermic needlestick and other sharps injuries are up 16% from a decade ago, according to AORN.
When Karen D. Orr, PA-C/CEO suffered a needlestick injury a few years ago and the patient had known Hepatitis C, she wondered why there wasn’t a product on the market to keep healthcare workers safe when using hypodermic needles. She soon had an idea for a new safety device that secures hypodermic needles.
Her idea became HypoHolder, a safety engineered medical device that allows healthcare workers to uncap, recap and dispose of the hypodermic unit with just one hand. “At least 70 percent of hypodermic needlestick injuries occur during these three tasks,” says Orr.
HypoHolder is now being used in two non-human primate research facilities and being demonstrated at two Level I hospitals and two ASCs. “All six of the facilities have had a higher than average number of hypodermic needlestick injuries, but there have been zero injuries since HypoHolder has been in use,” says Orr.
Orr and her team are currently in talks with a Level I trauma center with Magnet status for a major research project on hypodermic needlestick injuries and applying for a government grant to help fund it. “Healthcare is hard right now, so we want healthcare workers to know there are people who care about and appreciate them and the care they provide,” she says.
Technology to Support Safer Surgery
Perioperative consultant Vangie Dennis, MSN, RN, CNOR, FAORN, FAAN, believes we’re witnessing a plethora of new and emerging technologies that are improving OR safety by reducing human error, improving situational awareness and preventing complications.
“Together, these technologies support safer surgeries for patients and a safer work environment for OR personnel,” says Dennis.
Here are a few of her favorite surgical technologies and how they enhance safety in the OR:
- Surgical navigation and image-guided systems: These provide real-time 3D visualization using CT/MRI data. “This help surgeons avoid critical structures such as nerves, vessels and organs and improves accuracy in spine, neuro and orthopedic surgery,” says Dennis.
- Robotic-assisted surgery: Magnified 3D visualization filters hand tremors, improves precision and enhances dexterity while reducing tissue trauma, blood loss and surgical complications.
- AI-Powered clinical decision support: This analyzes patient data to predict complications such as bleeding, infection and sepsis and alerts perioperative teams to early warning signs in real time. “It also assists with dosing, timing and procedure planning while reducing cognitive overload and preventing errors,” says Dennis.
- Smart surgical instruments: These provide tactile or visual feedback when excessive force is applied and automatically adjust energy delivery (e.g., smart cautery devices), which reduces accidental tissue damage.
- Advanced patient monitoring systems: These continuously monitor vitals, oxygenation and brain activity to detect subtle changes earlier than traditional monitors. This enables faster intervention and reduces anesthesia-related risks while supporting enhanced recovery after surgery.
- Augmented reality (AR) and virtual reality (VR): These technologies overlay critical anatomy during procedures. “They also improve pre-op planning and surgical rehearsal and enhance training without putting patients at risk,” says Dennis.
- Smart OR integration systems: These integrate monitors, devices, imaging and documentation to reduce clutter and cable hazards in the OR, improve communication and reduce workflow errors.
- Antimicrobial and self-disinfecting technologies: Antimicrobial surfaces and UV disinfection reduce contamination, lower surgical site infection (SSI) rates and enhance turnover safety between cases.
- RFID and barcode tracking systems: These track sponges, instruments and implants in real time to help prevent retained surgical items. “This technology also improves instrument accountability and workflow accuracy,” says Dennis.
- Enhanced smoke evacuation and air filtration systems: These remove hazardous surgical plume and airborne pathogens from the OR, reducing patient and staff exposure to toxic chemicals and bioaerosols.
Laser Technology: Risks and Safety
Laser technology has transformed modern medicine and healthcare over the past few decades. “Lasers offer several key safety advantages in precise surgical procedures compared with traditional instruments,” says perioperative consultant Patti Owens, MHA, BSN, RN, CMLSO, CNOR, FAOR. These include greater precision and control, less trauma to tissue, reduced bleeding, reduced post-operative pain and swelling, lower infection risk, and improved healing and recovery.
However, the use of lasers is associated with a variety of hazards and potential risks that can affect the safety of OR personnel and patients. Patient risks include thermal injury, ocular damage, airway fire risk, delayed tissue damage, laser plume exposure and improper tissue interaction. OR personnel risks include ocular injuries, skin burns, laser plume exposure, and fire and electrical hazards.
“Lasers are very safe when they’re properly controlled, but this requires strict safety awareness from the entire surgical team,” says Owens. “When everyone follows laser safety protocols, laser-related injuries are largely preventable.”
Owens lists a number of practical, proven steps OR personnel can take to reduce the risk of laser exposure:
- Take personal protective measures. “Wavelength-specific laser safety eyewear should be worn at all times when the laser is in use,” says Owens. Also ensure proper eye protection for the patient, including laser-safe eye shields or goggles.
- Exercise environmental controls. These include posting appropriate laser warning signs outside the OR and restricting access during laser use. Also, close doors and cover windows with an appropriate occlusive barrier to contain laser energy.
- Make sure equipment is safe. Inspect laser equipment before use for damage or malfunction and confirm the correct settings (e.g., power, mode, wavelength) prior to activation. “Keep the laser in standby mode when not actively firing and never leave an activated laser unattended,” says Owens.
- Follow proper procedures. For example, always announce “Laser on” and “Laser off” clearly to the team. Only designated, trained individuals are allowed in the laser treatment room. And avoid directing the beam toward non-target tissue.
- Ensure proper training and accountability. Owens stresses that all OR personnel using lasers should complete laser safety education and competency validation. “Personnel should follow the facility’s laser safety policies and checklists and speak up immediately if any unsafe practices are observed,” she says.
Owens and Dennis are leading a Medical Laser Safety Officer virtual training course in 2026. The course is designed to provide OR personnel with a foundation of laser biophysics, tissue interaction, safety and administrative responsibilities.
The course will be offered April 18-19, July 18-19 and November 7-8. Visit medicallasersafety.com to register.
