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

1 Approved October 11, 2013 Revised April 23, 2014 Revised February 1, 2017 AST Guidelines for Best Practices on the Perioperative Role and Duties of the Surgical Technologist During Robotic Surgical Procedures Introduction The following Guidelines for Best Practices were researched and authored by the AST Education and Professional Standards Committee, and are AST approved. AST developed the guidelines to support healthcare delivery organizations (HDO) reinforce best practices in the role and duties of the surgical technologist during robotic surgical procedures as related to the role and duties of the Certified Surgical Technologist (CST®), the credential conferred by the National Board of Surgical Technology and Surgical Assisting. The purpose of the guidelines is to provide information OR supervisors, risk management, and surgical team members can use in the development and implementation of policies and procedures for the role and duties of the CST during robotic surgical procedures in the surgery department. The guidelines are presented with the understanding that it is the responsibility of the HDO to develop, approve, and establish policies and procedures for the surgery department regarding the role and duties of the CST during robotic surgical procedures practices per HDO protocols. Rationale Robotic surgery is defined as a surgical procedure or technology that adds a computer-assisted electromechanical device to the interaction between the surgeon and the patient. 6 Examples include micromanipulators, remotely-controlled endoscopes, and console-manipulated devices. 6 These devices enhance the surgeon’s vision, tissue manipulation, and tissue-sensing which alter the traditional surgeon-surgical wound direct contact. Robotic surgery devices have developed well beyond the investigational stage and their use in the OR has become an accepted method for performing minimally invasive surgery (MIS) in most surgical specialties on a routine basis. Small healthcare to large research facilities are purchasing surgical robots and training their surgical personnel in the use of the robots. The surgical robot continues to evolve in development (first generation surgical robots had two manipulators (arms) and the current generation has four; henceforth, the layman term “arms” will be used throughout the document), and surgical applications; additionally, in anticipation that they become more economical to purchase their usage is anticipated to continue to increase. The most well-known robotic system is the da Vinci®; the most recent generations are the da Vinci S HD , da Vinci Si , and da Vinci Xi that are hi-definition, 3-dimensional vision systems that consist of the patient cart, surgeons console with foot pedals, and vision cart that contains the camera, focus controller, light source, electrosurgical unit, and equipment. 1, 15 Additionally, specially designed EndoWrist® instruments that provide a full range of motion and precision are used by the surgeon.