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

16 ___ Creates a trough for the endoscope and pushes sterile camera arm adapter firmly in place. ___ Aligns the pins on the camera cannula mount with the reinforcement and hole in the drape, and snaps it into place. ___ Demonstrates the “sweet spot” rule for the camera arm. ___ Places instrument arms in a “hugging” position after completion of draping. ___ Drapes the robotic endoscope to the camera processor properly. Camera and Endoscope Calibration: ___ Attaches the endoscope alignment target with the crosshairs running vertically and horizontally to the tip of the endoscope. ___ Demonstrates correct positioning of endoscope tip in endoscope alignment target for each endoscope, i.e., straight, up and down. ___ Communicates to circulator which endoscope and position of endoscope, i.e., straight, up and down. EndoWrist® Instrument Placement and Removal: ___ Inspects the EndoWrist® instrument for cracked, chipped or worn parts. ___ Checks that sterile adapter carriage is at the top of the instrument arm and instrument wrist is straight with tips closed. ___ Uses hand to stabilize the instrument arm, and the other hand to align rails on the instrument with grooves on the sterile adapter. ___ Inserts the tip of the instrument into the cannula and then slides the rails on the instrument into the grooves on the sterile adapter. ___ Presses clutch button for first insertion of instrument. ___ Slowly introduces EndoWrist® instrument until the instrument tip is just visible emerging from the distal end of the cannula under direct observation of assistant monitor. ___ Presses the clutch button again only after initial insertion of instrument. ___ Checks with surgeon at surgeon console that instrument jaws are open, wrist is straight, and not clamped on any tissue. ___ Uses one hand to stabilize the sterile adapter and the other hand to depress the release tabs on the instrument. ___ Squeezes the release levers on the sides of the EndoWrist® instrument and gently pulls the instrument out of the sterile adapter while observing on assistant monitor. ___ Checks that the sterile adapter returns to the top of the instrument arm after removal. ___ Demonstrates knowledge of icons and their meaning. ___ Demonstrates correct subsequent instrument insertion and removal. ___ Demonstrates correct camera/endoscope attachment and removal. ___ Demonstrates proper cleaning of EndoWrist® instruments during case. ___ Demonstrates correct handling of sutures for robotic cases. ___ Demonstrates proper draping sequence for robotic case.