The principles of operating theater (OT) integration are based on concepts that were established in the late 1960s and early 1970s. Originally, the concept of an integrated OT consisted of a surgeon who would operate on a patient located on a central surgical table with all the necessary equipment available on mobile carts operated by nurses. However, the advancement of technology in the late 20th century precipitated a change in how OT integration was approached. Modern integrated OTs were introduced to the market place in 1992 and focused on video routing and the distribution of video signals from one camera to multiple monitors. Since then, the concept of integration has evolved and integrated OTs often include high resolution video displays, multi-modality connectivity, centralized touch screen control and digital information archiving that often allows the OT to exchange information with external locations and enables the efficient placement of ergonomic equipment.