Study Notes for Surgical Technology

Chapter 1: Introduction to Surgical Technology

Case Study

  • Scenario: Patient scheduled for diagnostic laparoscopy for chronic pelvic pain.

  • Roles Identified:

    • Registered Nurse (RN): Functions in the nursing role by conducting evaluations, checking documentation, confirming allergies, and providing emotional support.

    • Certified Surgical Technologist (CST): Emma, who assists the surgeon by setting up instruments and maintaining sterile environments.

  • Questions:

    1. What nursing role is the RN functioning in?

    2. In what surgical technologist role is Emma functioning?

    3. What organization is responsible for accrediting Emma’s program?

    4. What is Emma's preferred educational background as established by the accrediting organization?

    5. What organization offers the CST examination that Emma passed?

Learning Objectives

  • C 1-1: Demonstrate the principles of communication in the surgical setting.

  • 1-2: Analyze the components of effective teamwork and communication.

  • A 1-3: Trace the historical development of surgical technology.

  • 1-4: Recognize members of the surgical team and their roles.

  • R 1-5: Describe professional organizations related to surgical technology:

    • Association of Surgical Technologists (AST)

    • Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA)

    • National Board of Surgical Technology and Surgical Assisting (NBSTSA)

  • 1-6: Compare the various roles of the CST.

  • 1-7: Interpret the components of a job description for the CST.

  • 1-8: Discuss surgical conscience and its application to surgery.

  • E 1-9: Summarize types of healthcare facilities.

  • 1-10: Analyze a hospital's organizational structure.

  • 1-11: Describe the relationships of hospital departments to surgical services.

Key Terms

  • Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA)

  • Ambulatory Surgery Center (ASC)

  • American College of Surgeons (ACS)

  • Association of Surgical Technologists (AST)

  • Circulator

  • Competency

  • Confidentiality

  • Core Curriculum for Surgical Technology

  • Doctor of Osteopathy (DO)

  • Elective Surgery

  • Emergency Surgery

  • Health Maintenance Organization (HMO)

  • Intraoperative

  • Joint Commission (TJC)

  • National Board of Surgical Technology and Surgical Assisting (NBSTSA)

  • Optional Surgery

  • Perioperative

  • Postoperative

  • Preceptor

  • Preoperative

  • Professional

  • Proprietary

  • Surgical Conscience

  • Surgical Technologist

  • Urgent Surgery

History of Surgery

  • The history of surgery intertwines insights into human anatomy and philosophy.

  • Classical Period: Contributions by Hippocrates and Aristotle, based on philosophical means rather than scientific method.

  • Middle Ages: Intellectual stagnation post-Rome with lost handwritten documents.

  • Renaissance: Overthrew long-standing anatomical teachings; emphasized anatomical studies, including Vesalius’ detailed illustrations.

  • Modern Surgery: Emerged from advances in pain management, infection control, and hemostasis, enabling previously untreatable conditions.

  • Future Directions: Expected developments like targeted therapy drugs, bioengineered tissues, and gene therapy.

History of Surgical Technology

  • Modern surgical technology began in the UK and US post-World War II.

  • Nonphysician assistants in surgery date back to ancient practices; military reliance on nonphysician assistants grew especially when women were excluded from battlefields.

Key Events in Surgical Technology
Table 1-1 - Select History of Surgery Timeline (Approximate Dates)

  1. 4000 B.C.: Cuneiform script - earliest anatomical descriptions.

  2. 2500 B.C.: Imhotep - Egyptian physician; early surgery texts.

  3. Examples of important figures and their contributions:

    • Hippocrates: Medical practices reflecting insight despite religious ties.

    • Galen: Influential in anatomy for 1,500 years.

    • Andreas Vesalius: Father of modern anatomy; pushed for human dissection.

    • Edward Jenner: Introduced smallpox vaccine.

    • Louis Pasteur: Father of microbiology and immunology.

    • Joseph Lister: Antiseptic surgery pioneer.

    • Harvey Cushing: Neurosurgery figure reducing mortality rates significantly.

Table 1-2 - Select History of Surgical Technology Timeline

  1. Late 19th Century: Mr. Rampley as a surgery beadle.

  2. 1969: Formation of the Association of Operating Room Technicians (AORT).

  3. 1974: Liaison Council on Certification for Surgical Technology established.

  4. 1985: AORT changes to AST; publication of the Core Curriculum for Surgical Technology.

Role of the Surgical Technologist (CST)

  • CST Responsibilities:

    • Facilitates safe surgical procedures; ensures proper equipment functionality; applies knowledge of aseptic techniques and anthropology.

  • Important Organizations:

    • AST Mission Statement: "Enhancing the profession to ensure quality patient care."

    • Collaborates with ARC/STSA and NBSTSA for standards in education and certification.

  • Continuing Education: Required to maintain CST credentials and assure skills are current.

Professional Healthcare Organizations

  • American College of Surgeons (ACS): Improves surgical patient care quality.

  • American Medical Association (AMA): Ensures effective physician practices.

  • Centers for Disease Control and Prevention (CDC): Monitors health statistics and disease outbreaks.

  • The Joint Commission (TJC): Develops accreditations and standards for healthcare organizations.

Surgical Technology Education

  • Accreditation Standards: Programs accredited by CAAHEP or ABHES; eligibility for national CST exam through NBSTSA.

  • Certification Maintenance: Certification via completion of continuing education; may be required by employers or state legislation.

Employment and Career Development

  • Skills Required:

    • Dedication: Empathy, non-discrimination, and strong ethics.

    • Communication: Effective verbal, nonverbal, and problem-solving capabilities.

    • Responsibility: Reliability, adaptability, and commitment to ongoing education.

  • Job Descriptions: Key elements must be clear to ensure understanding of expectations and duties in the surgical environment.

Surgical Team and Roles

  • Sterile Team Members: Include the surgeon, CST in first scrub role, and surgical first assistant.

    • First Scrub CST: Preoperative case management, maintaining sterile field, passing instruments, and postoperative duties.

  • Nonsterile Team Members: Include anesthesia provider and circulator, responsible for patient transport, obtaining consents, and overall operative care function.

Essential Characteristics of CST

  1. Physical Requirements: Manual dexterity, stamina, and ability to concentrate.

  2. Communication Skills: Respectful, clear expression of needs, active listening.

  3. Ethical Responsibility: Adherence to patient confidentiality and nondiscriminatory treatment.

Team Dynamics and Communication

  • Team dynamics in surgery require respectful, collaborative interaction to ensure efficient care delivery and minimize errors.

  • Strategies for Effective Communication:

    • Respect and politeness.

    • Keeping focused on surgical tasks and clear communication of needs.

Conclusion and Case Study Application

  • Understanding CST roles and communication strategies is crucial for improving patient care and surgical outcomes. The effective collaboration between surgical team members contributes significantly to patient safety.

Questions for Further Study

  1. What is the difference between a job description and a role description?

  2. How does healthcare financing affect the services that healthcare professionals provide?

  3. List several reasons why a CST might need to communicate with various departments.

  4. Describe a typical workday for the CST.