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

8 (5) The camera arm is draped in the same way. The S systems require a camera arm sterile adapter. Depending on when the HDO purchased the system, some systems require a separate sterile endoscope trocar mount, while other systems the mount is permanently attached. (6) Next, the touchscreen monitor is draped. (7) The endoscope is draped by connecting the camera sterile adapter to the endoscope and taping the drape to the sterile adapter. The camera head is connected to the endoscope and the drape inverted over the camera head and optical cables. (8) The sterile light cable is connected to the endoscope and the camera and endoscope are activated. The CST completes the white balance of the endoscope/camera head apparatus by using a sterile piece of white paper. The CST can complete the white balance using the camera head or touchscreen monitor. (9) The CST now completes the 3D calibration to align the endoscope and establish the endoscope settings. The CST uses the alignment target on the tip of the endoscope in conjunction with the camera head or touchscreen monitor. Each endoscope that may be used during the procedure must be calibrated. (10) The last step completed by the CST is setting what is referred to as the “sweet spot” of the camera arm by aligning the trocar mount with the center of the patient cart column and extending the camera arm to establish about 20” of space between the back of the camera arm and patient cart. The CST should use the guide on the camera arm that helps to set the sweet spot. This step is necessary to allow for maximum range of motion (ROM) of the arms and prevent hitting each other. 5. CST completes additional routine duties prior to the start of the intraoperative phase including gowning and gloving the surgeon(s); assist with draping the patient; set up electrocautery, suction, camera, and light cords. Intraoperative Guidelines Guideline VII The CST at the sterile field assists the surgeon in performing a safe robotic surgical procedure. 1. During the intraoperative phase the CST carries out the following duties to assist the surgeon in the performance of a safe robotic surgical procedure. This list is not all inclusive since there are multiple routine duties the CST completes during any type of surgical procedure. A. The CST follows the standard procedure in assisting the surgeon with insertion of the trocars. (1) After the pneumoperitoneum is established, a 12 mm trocar with sheath is placed to be used for the endoscope; another 12 mm trocar is placed for the camera arm. (2) 5 or 8 mm sheaths with blunt or sharp trocars are placed for the instruments arms.