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Roles of an Assistant Surgeon in the Operating Room

by Darlene Peer

An assistant surgeon is often present for major operations and, according to the American College of Surgeons, should be able to actively help and participate in operating safely. This involves providing exposure, maintaining hemostasis and helping with other technical functions. The assistant surgeon will find that her role will vary depending on the type of surgery being performed and the type of hospital or facility in which it is taking place.

Assistant Surgeon Background

If the operation is taking place in a teaching hospital, the assistant surgeon is likely a senior resident or fellow who is present to observe, help or even perform most of the surgery under an experienced surgeon's eye. In other hospitals, it may be a qualified registered nurse or even another surgeon helping out. Shortages or hospital policy may mean that a surgeon's assistant or physician's assistant will be used as the first assistant in surgery. The first assistant's background and experience have an impact on her expected duties in the operating room. Sometimes, the patient's health and background will dictate whether the first assistant in surgery should be an assistant surgeon.

Pre-Op

Before surgery begins, the assistant surgeon will go over the facts with the operating staff to ensure that everyone knows what's expected and any possible complications to watch for. He'll ensure that they have the correct patient information, verify the operating procedure, inspect the surgical site beforehand and double check the patient's files for any abnormalities that need to be flagged for the surgeon. With patient comfort and safety in mind, the assistant surgeon ensures that the proper equipment is present and properly padded. Circulation has to be good, and the patient's temperature must be maintained.

Basic Role During Surgery

The assistant surgeon helps secure the operating site by placing and securing retractors; packing sponges; moving and manipulating tissue if needed; sponging, suctioning, or irrigating the area as needed; controlling suture materials; and ensuring that the surgeon has an unobstructed view of the area. To help achieve hemostasis, the assistant surgeon will clamp, cauterize, tie or ligate vessels and tissue, apply clips and place localized hemostatic agents, along with applying tourniquets, vessel loops, clamps and direct pressure as needed.

End of Operation and Post-Op

The assistant surgeon may be responsible for closing the wound after surgery. This can include choosing and applying wound dressing, applying absorbent materials and immobilizing wound dressing. If a drainage system is needed, the assistant surgeon will be responsible for securing it. When the surgery is completed, the assistant surgeon will asses the patient to ascertain whether the skin has been damaged due to positioning and will report any abnormalities. There may be other post-op duties, depending on the surgeon's directions and the policy of the surgical facility.

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