CENTER PIECE Your selection of surgical lighting, as with your choice of operating tables, is a critical decision in equipping or upgrading an OR.

It can get confusing trying to compare your LED light options. If you're seeking to equip or upgrade your ORs with light-emitting diodes, here's help making sense of manufacturers' claims that they have the brightest, coolest, whitest, lowest maintenance LEDs, as well as a roundup of the latest LED options.

How do I measure LED light quality?
Quantifying the quality of illumination that OR lights cast over the surgical site is a good way to begin your comparison between different manufacturers' models. Light quality is communicated by way of intensity and color temperature, details that most companies readily mention in their marketing.

• Intensity (lux). The intensity, or brightness, of light depends on the strength and arrangement of its source. Illumination is most often measured in units called "lux," with a higher number indicating a brighter light. One lux equates to 1 lumen of light over 1 square meter. Direct, overhead sunlight is about 130,000 lux. Although surgical lights can reach a maximum of 160,000 lux, many products do not max out, as higher levels of intensity can create glare on the surgical site.

• Color temperature (degrees Kelvin). The color temperature of light is an indication of how accurately it shows the subject's true color. It is measured in degrees Kelvin ( ?K), with higher numbers representing whiter light and, as a result, more realistic color, since any tints in the illumination can affect the subject's appearance. Color temperatures of 4,000 ?K to 6,000 ?K (the range of many LED lights) approximate natural daylight. Higher temperatures than that are slightly bluer. In comparison, halogen bulbs have a slight yellow tint in their 3,000 ?K range.

What else can my LED do?
As a purchase, surgical lighting is a decision that's made for the long term. Those in the market for OR lights are most often equipping a newly constructed OR or undertaking a wholesale renovation project. In either one of those situations, there's a lot of technology being installed at once, and many of the latest surgical lighting units offer more than just bright light.

Several LED lighting systems are available with optional in-light cameras, which feed an overhead view into an integrated OR's video imaging system for clinical reference or educational purposes. The integrated OR often incorporates equipment booms into lighting systems for technology connectivity, or at least keeping cords off the floors. And an OR hosting endoscopy, laparoscopy or other procedures that rely on video monitors to see the surgical site might value light-dimming or ambient lighting functions, which enable the surgeon an optimal view of the screen while allowing the rest of the surgical team to handle their tasks and see their way around the room.

Equipment planners note that when surgical lighting is installed as part of a multi-component integrated OR, it is common to purchase each piece and work through the installation with a single vendor, due to the technical and economic benefits it usually brings. If your plan forgoes vendor uniformity, though, planners stress the importance of confirming the compatibility of each component before the purchase and installation.

What do others think of it?
Even if it's classified by lux and degrees Kelvin, light is a subjective experience. The way that light looks as it illuminates a space depends entirely on the space that you see it illuminating. In other words, an exhibit hall or a manufacturer's showroom is not the place to make a decision on which surgical light to buy for your facility.

In order to judge how well a light works in your own OR, without the downtime and expense of uninstalling your current light and replacing it with a demo model for the trial, you could ask the manufacturer to provide a temporary stand on which to set it up. But many equipment planners recommend visiting a facility of approximately the same size and with a similar case mix to yours that has purchased the unit you're considering, in order to see the light. The vendor's rep should be able to tell you who else in his territory has one.

This offers the additional benefit, the planners say, of putting you in contact with people who have used the lighting system in actual surgeries for a substantial amount of time. They can tell you how maneuverable and stable the lights are, how well their focus and shadow controls work in practice, and whether they've met the surgeons' needs. These hands-on testimonials, along with vendor-supplied 3D room plans to prevent collisions between lights, boom-mounted equipment or surgical staffers' heads, can shed a lot of light on your lighting choices.

Berchtold
Chromophare F628 with Precision Beam Technology
berchtoldusa.com
(800) 243-5135
Pricing: $25,000 to $29,000 for dual light set
FYI: This lightweight, ultra-thin and highly maneuverable LED focuses 650 beams of overlapping light into a homogenous column, providing illumination depth and shadow control. The proprietary Precision Beam Technology combines the power of 104 LEDs with a reflector to multiply and redistribute light onto the surgical field.

DRE Medical
Maxx Luxx LED Surgical Light
dremed.com
(800) 462-8195
Pricing: starts at $7,500
FYI: Provides 120,000 lux and a color temperature of 4,300 ?. Offers around 50,000 hours of use as compared to an average halogen bulb life of 1,500 hours. It also reduces electricity consumption; delivers whiter, more color-correct light; and virtually eliminates the heat of the light head and beam.

Maquet Medical Systems
PowerLED Surgical Light
maquetusa.com
(888) 627-8383
Pricing: not disclosed
FYI: Provides 110,000 lux of warm white LED light that's always in focus. The resulting volume and depth of field deliver a consistent light patch that renders tissue color accurately. Lightweight and easy to maneuver, the unit's Automatic Illumination Management feature adjusts the light to minimize shadows caused by surgical personnel. PowerLED lights include ambient lighting features, are integration-ready and have high-definition in-light camera options.

Nuvo
VistOR MS LED Surgical Light
nuvosurgical.com
(800) 663-1152
Pricing: $8,700 to $16,942
FYI: Designed for the budget-conscious surgical facility, Nuvo's new VistOR MS LED surgical light (pictured with dual light heads and a monitor) provides bright surgical illumination and effective shadow control and pattern adjustment through 60 high-efficiency, cool-temperature LEDs. Delivering 120,000 lux and 30,000 hours of use, the VistOR MS is available in single, dual or triple ceiling-mounted systems. On/off and intensity settings are controlled from the sterile handle.

Oricare
L2700 Series Operating Room Lamps
oricaremed.com
(215) 538-2470
Pricing: starts at $12,000 for single, $21,000 for double, $68,000 for double with HD camera system
FYI: The warm white output from the Oricare L2700 Operating Room Lamps' LEDs is similar to natural daylight, enabling quality visualization and visual comfort. The advanced optics create a shadowless surgical environment with substantial lighting depth, natural color rendering and a long working life. Available in 2 sizes and various configurations, the system's patented suspension combines stability with a compact and streamlined appearance.

Skytron
Aurora 3 LED Surgical Light
skytron.us
(800) SKY-TRON
Pricing: $18,000 to $66,100
FYI: Gives the surgeon complete control of positioning, intensity and focus from the sterilizable center handle. It offers brilliant, color-correct and shadow-free illumination, with the option of selecting between 2 color temperatures, 4,100 ?K or the whiter 4,500 ?K. The 360 ? rotating pivot points on the arms and light head provide years of drift-free service. Multiple configurations are available, including the ability to add monitor arms, equipment booms, extended reach arms and the Precision HD in-light video camera.

Steris
Harmony LED Surgical Lighting and Visualization System
steris.com
(800) 548-4873
Pricing: not disclosed
FYI: The Harmony LED system's large, 160,000 lux spot of cool white light is made up of 84 overlapping beams to virtually eliminate the shadows of heads and hands. A color-rendering index of 97 provides high quality tissue differentiation. Can be upgraded with light heads, ambient light, monitors and cameras to accommodate video integration, and fiber optic cabling within the suspension enables crisp signals to HD monitors.

Trumpf Medical Systems
TruLight 5000
us.trumpf.com/med
(888) 474-9359
Pricing: not disclosed
FYI: Features up to 160,000 lux of illumination, with variable light pattern size and shadow control. Color temperature can be adjusted between 3,500 ?K and 5,000 ?K to ensure high-quality contrast and reduce eye fatigue. Adaptive Light Control Plus technology automatically provides optimal illumination of the surgical site, regardless of wound depth. The TruLight 5000 offers a thin, easy-to-position light head; advanced heat management system; long life cycle; and reduced power consumption and maintenance costs. Available options include the TruVidia HD in-light camera.