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

6 (3) The vision cart system contains a digital zoom so the surgeon can magnify the tissue without having to move the endoscope. (4) One of the more recent revisions to the Si patient cart involves the light source and camera control unit combined into a single connection. (5) The white balance is completed using the telemonitor. (6) The wheel locks are located on the rear wheels of the vision cart. 16 Guideline V The CST must have a thorough understanding of the specialty EndoWrist® instruments to properly handle and care for the instruments. 1. The instruments are manipulated by the surgeon at the surgeon console; they have seven degrees of freedom with a wide degree of articulation and rotation that simulate the movements of the wrist and hand. A. The CST must confirm the robotic system that is being used if the HDO has the standard and S systems because the instruments are not interchangeable between the systems. (1) The instruments for the standard system are 52 cm with grey-colored housing, whereas the S systems instruments are 57 cm with blue-colored housing. 7 B. Each instrument has a fixed life of 10 uses at which time it is discarded. 9 (1) The system tracks the number of uses remaining for each instrument and provides the information on the telemonitor. 9 The CST must pay careful attention to this information since the instrument arm will not function if an instrument that has exceeded the number of uses is inserted onto the arm. (2) The CST should have extra of each instrument available in the OR in the event an instrument has reached its number of uses. Guideline VI The CST should demonstrate the knowledge and skills with the preoperative preparation and setup of the system’s components. 1. The surgeon console, patient cart, and vision cart should be carefully transported into the OR to prevent damage. A. The components should be slowly and carefully transported per manufacturer’s instructions. (1) The patient cart is transported using the motor drive. (2) The robotic arms must be in the stow position and kept from moving during transportation to avoid damage, e.g. hitting a wall or door. B. The components should be arranged in the OR per the surgical procedure that allows maximum movement of the patient on the stretcher, provides the surgeon a clear view of the patient from the console, clear traffic pathways, and tension-free connections of the cables between equipment. (1) The components should be arranged according to non-sterile and sterile areas to keep traffic and communication pathways clear. a. The surgeon console is arranged in the non-sterile area that allows the surgeon a clear view of the patient and sterile field. b. The vision cart is arranged in the non-sterile area that can be accessed by the circulator and viewed by the CST.