Training

If you are a practicing surgeon and would like to observe, or learn about no-mesh or various techniques, please send us an email with your CV to training@coberhernia.com.

The best surgeon-assistant duos usually have been working together for years and have a good rapport and get along in and out of the OR. But not all assistants have the luxury of regularly working together with a particular surgeon. The role of an assistant is crucial to the smooth conduct of an operation. The best assistants can make the least of surgeons look good. Here are some tips collated from some superb assistants over the years:

1. Help prep the patient to minimize the time between induction and skin incision. Help the circulator nurse with various functions such as:

a. SCDs on prior to induction.
b. Safe and padded patient positioning.
c. Shaving the operative field.
d. Warm blankets.
e. Skin prep.

2. Be courteous and follow the lead of the operating surgeon.

3. Consider asking the surgeon if they prefer an active or passive assistant. You can also ascertain this by how the surgeon utilizes you. Most surgeons prefer a balance, but some are very oriented in one direction. Here are some tips:

a. Don't retract too hard, just enough to see what is needed.
b. Closely follow the dissection to help with anticipation.
c. It is usually better to err on the side of being a passive assistant rather than being too active.

4. Anticipate next steps and act as an interface between the surgeon and the scrub tech to ensure that tools and supplies will be ready for the surgeon to use at the necessary time.

The role of the scrub tech is critical to the smooth conduct of an operation. A good scrub tech frees up the surgeon's mental powers to focus on the dissection, whereas a less involved scrub tech can lead to the operation progressing clunkily. Here are some tips collated from some superb scrub techs that we have had the pleasure of working with:

1. Ensure that the right equipment and tools are on the table or in the room.

2. Keep the instruments and field organized whilst not disrupting any particular movement patterns a surgeon may employ (e.g. keeping the Debakey near their left hand). 

3. Keep track of what might fall and how to keep the field efficiently organized.

4. When assisting it is better to err on the side of being passive and steady. Don't retract too hard, just enough to see what is needed.

5. Anticipate next steps and ensure the circulator has obtained what the surgeon may need shortly.

The circulating nurse is like an orchestra conductor. When the conductor is not fully present physically or mentally, things can get out of sync. Here are some tips collated from some great circulating nurses:

1. Prep as much as possible to minimize the time between induction and the skin incision:

a. SCDs on prior to induction.
b. Safe and padded patient positioning.
c. Shaving the operative field.
d. Warm blankets.
e. Skin prep.

2. Use closed-loop communication with the staff at the operating table to decrease errors and increase efficiency.

3. Ensure that all supplies are available before leaving the room and let the staff at the table know before leaving the room.

4. Keep abreast of the operation's progress and also anesthesia's physiologic status to anticipate any potential changes to the patient's condition.