Radiation dose to surgeons in theatre

Objectives. To evaluate the effects of ionising radiation and radiation limits, and measure radiation doses received by surgeons in theatre. Design. Thermoluminescent dosimeter measurements of accumulated dose to specific anatomical regions of a neurosurgeon, gastroenterologist and orthopaedic surgeon performing fluoroscopy on 39 patients undergoing treatment for back pain, 7 for endoscopic retrograde cholangiopancreatography procedures, and 48 for orthopaedic operations respectively. Results. Radiation dose levels with the X-ray tube above the table during back pain procedures exceeded the occupational annual recommendation to the neurosurgeon’s hands. The protocol regarding the orientation of the C-arm was changed. Convincing evidence of the importance and effectiveness of lead shielding was recorded. Conclusions. Constant revision of protocols should apply the as-low-as-reasonably-achievable principle in every unique setting. The ideal is to position the image intensifier above the theatre table. The longest possible distance from the source will lower radiation risk. Full-body protection of 0.35 mm lead equivalence during fluoroscopy is mandatory.