Back Table Setup for an Open Umbilical Hernia Repair
Devon Massey, CST; Shirin Towfigh, MD
Beverly Hills Hernia Center
Surgical instrument tables are considered as basic furniture for the operating room (OR). The largest table, typically rectangular or “L”-shaped, serves as a central hub for arranging and storing sterile supplies until needed during surgical procedures. The Mayo stand is an extension of the large table. It is small, height-adjustable, and intended to hang over the operating table and hold instruments and other sterile items for immediate use and within easy reach for the scrub nurse. Both the large table and the smaller Mayo stand are often referred to as back tables.
The specific equipment and arrangement of the back table may vary depending on the type of surgery and the surgeon’s preferences. This video provides a detailed, step-by-step guide to the back table setup for an open umbilical hernia repair surgery. It covers the preparation of the surgical field, the handling of sterile supplies, and the organization of the surgical tray. Additionally, it discusses the importance of adhering to sterile technique and the surgeon’s preferences during the procedure.
Surgical Staplers
Brandon Buckner, CST, CRCST
Lamar State College Port Arthur (TX)
For nearly two centuries, surgeons have been using mechanical devices to approximate tissues and facilitate their healing process. Currently, surgical staplers are widely used and have become essential tools in surgery. Staples facilitate rapid wound closure, hence shortening the duration of the surgical procedure. In comparison to intradermal sutures, stapling is associated with better cosmetic outcomes.
Staplers are classified into five categories: circular, linear, linear cutting, ligating, and skin staplers. With distinct names, color-coded features, and variations in length and tissue thickness, each stapler serves a specific purpose in the surgical setting. The distinct characteristics of various tissue types in the human body significantly influence the selection of staples. This video aims to provide a comprehensive overview of stapling instruments and their associated use.
Laparoscopic Instruments
Brandon Buckner, CST, CRCST
Lamar State College Port Arthur (TX)
The origins of laparoscopic surgery trace back to the introduction of diagnostic laparoscopy in the 1960s. Subsequently, the approach underwent a notable evolution, transitioning from a primarily diagnostic procedure to a surgical technique. Laparoscopy, a type of minimally invasive surgery, was introduced to address issues related to significant tissue trauma, large cosmetic scars, and prolonged hospitalizations. This video provides a step-by-step demonstration of the assembly, disassembly, use, and handling of laparoscopic tools on the example of a basic Karl Storz laparoscopy kit.
Opening Sterile Surgical Instrument Containers
Brandon Buckner, CST, CRCST; Crystal Romero
Lamar State College Port Arthur (TX)
In contemporary healthcare settings, the need to balance efficiency, cost-effectiveness, and environmental responsibility has led to the widespread adoption of reusable containers for surgical instruments. This video demonstrates the advantages of employing reusable rigid containers for surgical instruments, using a laparoscopic set from Baptist Hospitals of Southeast Texas as a case study.
Opening Sterile Surgical Packs
Brandon Buckner, CST, CRCST
Lamar State College Port Arthur (TX)
Surgical site infection (SSI) poses a significant risk to patients undergoing surgery. The prevalence of SSI is influenced by various factors. Within an ideal perioperative environment, exclusively sterile surgical instruments are employed. Care should be taken to thoroughly explore all methods of maintaining a contamination-free operating room (OR) environment.
The proper opening of sterile surgical instrument packs has critical importance in maintaining aseptic conditions in the OR. This video demonstrates all the nuances of this process, emphasizing the importance of package integrity checks and adherence to strict protocols for sterile surgical attire.
Surgical Sutures
Brandon Buckner, CST, CRCST; Crystal Romero
Lamar State College Port Arthur (TX)
Surgical sutures, an essential component of wound closure, are designed to facilitate the healing process. Most surgical or traumatic wounds require approximation of the wound edges of some kind. Typically, this is more often performed using sutures, rather than staples or surgical adhesives. Suturing provides a number of advantages, including reduced rates of wound dehiscence and higher resistance to tension compared to alternative methods of approximation.
Scalpels
Brandon Buckner, CST, CRCST
Lamar State College Port Arthur (TX)
Surgical instruments have a long history, but their modern versions have only been around for a relatively short period of time. Available in different shapes and sizes for diverse surgeries, contemporary scalpel blades and handles are typically crafted from hardened and tempered steel, stainless steel, and high carbon steel, with blade shapes designed according to their intended use. Recognized as indispensable surgical tools, scalpel blades contribute to precise incisions and minimal scarring, which is particularly crucial in minimally invasive, ophthalmic, cardiovascular, and endoscopic surgeries. Cutting in a firm and controlled way, usually at angles of 30–90 degrees from the tissues, necessitates holding the instrument in various ways, often placing a steadying forefinger along the back of the instrument. The tissue through which the scalpel is incising should also be steadied and put under a slight degree of tension.
The demonstration of surgical scalpels in this video provides valuable insights into their usage. The handles are available in different designs, serving two functions: fitting the appropriate size of surgical blades and ensuring a firm hold to reduce the chance of slipping.
Surgical blades come in sterile packaging, and the number on a surgical blade communicates both its size and shape. This video demonstration aids in understanding how each blade is tailored to meet certain demands in surgery.
Surgical Technologist Prepares the OR for a Case
Lauren Beausoleil, CST
Massachusetts General Hospital
Establishing a sterile field, opening and organizing equipment and supplies, and preparing the operating room (OR) for a case are the foundations for ensuring an environment conducive to a safe and efficient operation. Surgical donning of gown and gloves is an integral component of infection control in the OR. Healthcare professionals must adhere to strict protocols to protect both patient and healthcare worker safety. Proper training, vigilance, and attention to detail are crucial in maintaining a sterile environment before and during surgical procedures. This article explores key considerations for healthcare professionals as they open up surgical equipment, establish and maintain a sterile field, doff and don gowns and gloves, and prepare the OR for a surgical procedure.
Logan Threet, AAS, CST, Director of Surgical Technology at Wichita State University discusses education resources for learning during the COVID-19 pandemic and recommends JOMI “… as a great tool for clinical and didactic students.”
Read the article at:
https://www.arcstsa.org/index.php/revising-the-lesson-plan-advice-on-moving-your-students-and-faculty-forward/
Jamey Watson, Program Chair – Surgical Technology at Athens Technical College, gave his students a 30 day trial subscription to JOMI this summer. Here’s what happened:
“…in my lecture this afternoon I took about 20 minutes to go over the JOMI website with the students, basically showing it to them just as an idea. When I finished, I shared with them that (Athens Tech now has) a month long all access trial. You would have thought I had given them a brand new car. They were so excited. And I am too.”
The New Gold Standard for Surgical Videos
