Surgery Today - The surgical team

Most surgical operations are performed not by the surgeon alone, but by a surgical team. Depending upon the complexity of the surgical procedure involved, the surgeon may have one or more assistants working him. The assistants may be interns or hospital residents who participate in the operation as a part of the advanced training in surgical techniques, or they may be other surgeons who are specialists in a particular field. An abdominal surgeon or orthopedic surgeon, for example, may be assisted by a neurosurgeon if the operation is likely to require a special knowledge of the nervous system as it affects another organ system.

The Anesthetist

The anesthetist, who is also likely to be a physician, specializes in maintaining the proper degree of anesthesia in the patient, while also helping to maintain the body's life systems. In addition to making the patient unaware of pain during the operation—sometimes by making him unconscious, sometimes without affecting consciousness—the anesthetist must keep the muscles and nervous reflexes in a proper state for the type of surgery to be performed. Each of the various functions, muscle relaxation, for example, requires a different anesthetic drug. Their performance must be perfectly coordinated to prevent complications during the operation. Obviously, the anesthetist must prepare a different combination of drugs for a child, an elderly person, a pregnant woman in labor, or a man with heart disease.

Other Members of the Surgical Team

As noted earlier, there are occasions when several surgeons are working more or less simultaneously on an accident victim with injuries to multiple organ systems. In such cases of emergency surgery, a general surgeon may supervise and coordinate the work of the other surgeons. The Chief Operating Room Nurse supervises and coordinates the activities of the scrub nurses who assist the surgeon in the actual operation, and the supply and circulating nurses who aid the rest of the surgical team by making available as needed the various towels, drapes, sponges, sutures, instruments, and other equipment.

One or more of the nurses wear gowns and gloves that have been sterilized so they can work directly with the surgeon and hand him equipment or supplies that he requests. Such a nurse is called a scrub nurse because he scrubs his hands and arms for ten minutes before the operation, just as the surgeon does. Other nurses in the operating room who do not wear sterilized gowns and gloves are not permitted to handle equipment directly but may be permitted to pick up sterilized materials with an instrument that has been sterilized. One or more orderlies, who are responsible for lifting the patient and keeping the operating room in tidy condition, complete a surgical team.

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