AST Guideline - Perioperative Role and Duties of the Surgical Technologist During Robotic Surgical Procedures

15 Appendix B CST Competency Checklist for the da Vinci® Surgical Robot System CST Name: ____________________ Preceptor Name: ________________ Date Internet Training Completed: ____________ Date Hands-on Training Completed: ___________ Log of Robotic Cases – Name and Date of Cases: 1. _____________________________________ 2. _____________________________________ 3. _____________________________________ 4. _____________________________________ 5. _____________________________________ 6. _____________________________________ 7. _____________________________________ 8. _____________________________________ 9. _____________________________________ 10. _____________________________________ Completion of Robotic Orientation: Preceptor Signature: _________________________ Date: _____________ OR Manager Signature: ______________________ Date: _____________ Draping Arms: ___ Unfolds the instrument arm drape to the sterile adapter reinforcement. ___ Slides the sterile instrument arm adapter into the sterile adapter. Raises the hinged portion to lock the adapter in place. ___ Opens sterile camera drape package and places arrow toward CSTs body. ___ Unfolds the closed end of drape until adhesive strip and reinforcement section are exposed. ___ Adheres the adhesive strip to the sterile camera arm adapter. ___ Places instrument arm drape over the top of the instrument arm without contaminating. ___ Places sterile instrument arm adapter hinges onto silver bar of instrument arm. ___ Pushes sterile adapter mount onto instrument arm until click heard and rotating of discs seen. ___ Checks discs for spongy feeling. ___ Aligns the sterile cannula mount for instrument arm with the holes in the drape. ___ Inserts the key into the slot on the instrument arm and twist lock in place. ___ Attaches drape straps in appropriate locations. ___ Moves the draped instrument arm away from the undraped camera arm by using set up joint. ___ Drapes the camera arm by aligning the sterile camera arm adapter with the carriage on the camera arm.