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

2 This demands the CST to have the technical knowledge to assist the surgeon in providing quality surgery that ensures the safety of the patient. Approach to Organization of Guideline As compared to other AST Guidelines, this guideline has a different approach regarding format and wording. The guidelines are placed under the general headings of Preoperative, Intraoperative, and Postoperative to sequence of the role and duties fulfilled by the CST. Additionally, the guidelines focus more on the “process”, meaning the specific “actions” the CST performs during robotic surgical procedures. For example, the CST is now “handing” surgical instruments to the robotic arm and assisting with specific actions such as insertion of an instrument into a port. 10 Essentially, it is no different from when the surgeon is across from the CST during non-robotic surgical procedures; the exception being, obviously, the surgeon is now at the surgeon’s console manipulating the extension of his/her own arms which is the robotic arms, and the CST must have the knowledge as related to the technicalities of the robotic device. Therefore, based upon inquiries received at AST by surgeons, CSTs, and OR supervisors regarding what is the role and duties of the CST during robotic surgery, this guideline includes specific process-based information. For the duration of the guideline the technical information will focus on the current generation of da Vinci models. Evidence-based Research and Key Terms The research of articles, letters, nonrandomized trials, and randomized prospective studies is conducted using the Cochrane Database of Systematic Reviews and MEDLINE®, the U.S. National Library of Medicine® database of indexed citations and abstracts to medical and healthcare journal articles. The key terms used for the research of the guidelines include: robotics; robotic surgery; da Vinci robotic system. Key terms used in the guidelines are italicized and included in the glossary. Guideline I The CST should complete training specific to the robotic device being used at the HDO. 1. As with any technology used in the OR, the completion of training by the CST is necessary in order to achieve competence with the robotic technology and surgical procedures. A. As a graduate of an accredited surgical technology program, the CST gained entry-level knowledge of robotic surgery. ( 1) The initial formal education on robotic surgery is primarily through didactic studies. 2 a. The surgical technology student should be familiar with the medical terminology specific to robotic surgery, e.g. degree of freedom or rotation, articulated, manipulators, telesurgery, and carry this knowledge into the OR as a CST practitioner. Knowledge of medical terminology contributes to the competency of the CST by being able to communicate with the other team members using the common robotic “language”, as well as an understanding of the robotic components and instrumentation. (2) There may be instances where the surgical technology student may have exposure to robotic surgery during surgical rotation; however, it depends upon if the HDO has a robot, and if the student is allowed to observe and/or scrub-in on robotic procedures.