Orientation to Surgical Technology & History of Surgery

1. Orientation to Surgical Technology & History of Surgery ST210 Concorde Career College

2. History Objectives: • Provide a timeline of events leading up to modern medical/surgical practice • Understand the development of the role of the surgical technologist • List and describe reasons for surgical intervention

4. History Refer to Table 1-1 Pages 4-5 (ST4ST) • Ancient Times • Dark Ages • Renaissance • Classical Period • Modern Age

5. Ancient Times 4,000 BC Cuneiform Script

6. Ancient Times • Imhotep • Circa 2,500 BC • Considered the first physician of recorded history • Wrote one of the first surgical texts • Considered divine due to his work

7. Ancient Times • Code of Hammurabi • Contains contractual laws and medical practices of the day • Many medical references are religious in nature Code printed on clay tablet

8. Ancient Times • Moses • Circa 2000 BC • Established laws for cleanliness • Caduceus • Numbers 21:4-9

9. Ancient Times • Circa 1500 • Ebers Papyrus • Egyptian Medical hieroglyphs • Hindu Vedas

10. Ancient Times • Circa 1,000 BC • Homer • Early Greek historian and mythologist • Described military medicine • Susruta • Father of Indian medicine

11. Classical Period (500 BC – 500 AD) • Hippocrates • 460 – 370 BC • Greek physician • The Father of Medicine • Introduced the concept that illness has a physical and rational explaination

12. Classical Period • Aristotle • 384 – 322 BC • Established early scientific mindset • Founder of comparative anatomy

13. Classical Period • Herophilos • 335 – 380 BC • Father of Anatomy • First to describe the pulse as a diagnostic tool/vital sign

14. Classical Period • Aulus Cornelius Celsus • 25 BC – 50AD • Greek Encyclopaedist • First to describe the cardinal signs of inflammation

15. Classical Period • Aelius Galen • 129 – 200AD • World’s first great anatomist • Observations remained unchallenged for over 1,500 years • Believed that science was ruled by theology and adapted writings to reflect this viewpoint

16. Dark Ages (500 AD – 1100 AD)

17. Dark Ages • Avicenna • 980 – 1037 AD • Persian philosopher • Wrote The Canon of Medicine • Revived Aristotle’s theories

18. Renaissance (1450 – 1600) • Paracelsus • 1493 – 1541 AD • Swiss physician • Disagreed with Galen and Avicenna, but could not prove his theories scientifically • Called the Luther of Medicine

19. Renaissance • Ambroise Pare • 1510 – 1590 AD • French barber surgeon • Greatest surgeon of the 16th century • Began ligating arteries after amputation • Stopped cauterizing wounds with hot irons and oils

20. Renaissance • Andreas Vesalius • 1514 – 1564 • Flemish anatomist • Father of Modern Anatomy • Openly challenged Galen • Performed dissections on human cadavers himself • Hired famous illustrators to depict his anatomic findings • Changed the world’s approach to anatomic discovery

21. Vesalius

22. Renaissance • William Harvey • 1578 – 1657 • First to accurately describe circulatory anatomy and physiology

23. Modern Age • Morgagni • Developed modern-day clinical pathology • Edward Jenner • 1749 – 1843 AD • Credited with discovering the small pox vaccine • Father of Immunology • His work has saved more lives than any other man

24. Modern Age • Louis Pasteur • 1822 – 1895 AD • French chemist and microbiologist • Father of Microbiology

25. Modern Age • Joseph Lister • 1827 – 1912 AD • Father of Asepsis • Used carbolic acid to cleanse wounds and sterilize surgical instruments

26. Modern Age • William S. Halsted • 1852 – 1922 • Developed techniques for meticulous wound closure • Halsted’s Principles of Tissue Handling • Developed sterile surgical gloves

27. Modern Age • Michael E. DeBakey • 1908 – 2008 AD • Developed the first ventricular assistive pump device • Invented critical components of the heart-lung machine • Inventions and discoveries made cardiac surgery possible • Developed and patented numerous surgical instruments

28. Modern Age • Denton Cooley • Born 1920 • Perfected the heart-lung machine • Performed first US heart transplant • Implanted first total artificial heart

29. What differences do you see?

30. History Once these three principles were identified and solutions found – modern medicine could emerge! • Infection • Pain • Hemorrhage

31. History Development of the Role of the Surgical Technologist • How/why did the profession originate? • How has surgical technology education evolved? • Why are you here?

33. History Reasons for Surgical Intervention • Trauma • Disease • Condition • Congenital Anomaly • Desire

34. History Classifications of Surgical Intervention • Emergent – Immediate threat to life or limb (requires immediate treatment) • Urgent – Urgent threat to life or limb (requires treatment within a short period of time) • Elective – Does not have to be performed within a short period of time (may be scheduled in the future) • Optional – Not pathological in the traditional sense (not necessary)

35. History Surgical Specialties • General Surgery (General) • Obstetric and Gynecologic Surgery (OB/GYN) • Ophthalmic Surgery (Eye) • Otorhinolaryngologic Surgery (ORL/ENT) • Oral and Maxillofacial Surgery (OMF) • Plastic and Reconstructive Surgery (Plastic) • Genitourinary Surgery (GU) • Orthopedic Surgery (Ortho) • Cardiothoracic Surgery (Hearts/Chest) • Peripheral Vascular Surgery (PV) • Neurosurgery (Neuro)

36. Workplace Management • CAAHEP: Commission on the Accreditation of Allied Health Education Programs • ARC/STSA: Accreditation Review Council on Education in Surgical Technology and Surgical Assisting • NBSTSA: National Board of Surgical Technology and Surgical Assisting • JC: Joint Commission, formerly known as the Joint Commission Accreditation of Health Care Organizations (JCAHO)

37. Phases of Surgical Care Management • Preoperative: prior to initiation of the surgical procedure • Intraoperative: while procedure is being performed • Postoperative: when surgical procedure is terminated

38. PREOPERATIVE CASE MANAGEMENT • PPE • OR Preparation • Sterile field (creating, organizing, maintaining) • Organizing • Assisting with gowning and gloving • Draping

39. INTRAOPERATIVE CASE MANAGEMENT • Maintain the sterile field • Handling of instruments, supplies, etc. • Preparing medications • Counting • Proper specimen identification and labeling • Dressing application

40. POSTOPERATIVE CASE MANAGEMENT • Maintain the sterile field until the patient is out of the room • Disassemble the sterile field • Patient transportation • Room turnover

41. SurgicalTeamMembers

42. NON-STERILE SURGICAL TEAM MEMBERS • Circulator(RN, LPN, or Surgical Technologist) • Anesthesia Provider • Radiology Technologist • Pathology • Surgical Observers • Anyone outside of the sterile field

43. CIRCULATING DUTIES • Preparing the OR • Conducting pre-op patient interview • Transporting to and from the OR (Pre-op, PACU) • Transporting the pt. to and from the OR table • Positioning • Prepping the skin • Assist with draping • Assist anesthesia • Counting, gathering supplies • Various cord hook-ups • Maintaining the OR record • Specimens • Dressings

44. Non-sterile Team Members

45. ANESTHESIA PROVIDER RESPONSIBILITIES • MD, DO, CRNA • Pt. assessment • Determining type of anesthesia • Discussing the risks of anesthesia • Monitoring vital signs • Providing supportive measures (airway, fluids)

46. STERILE TEAM MEMBERS

47. WHO ARE THEY? • Surgical Technologist • Surgeon • MD, DO, DPM, DDS, DMD • Surgical Assistant • CSFA, CSA, SA-C, CRNFA or RNFA, PA-C, OT-C or OPA-C, surgical resident, or other surgeon • CST (limited scope)

48. The Surgeon • Assumes full responsibility for all medical acts of judgment and management of the surgical patient

49. Surgical First Assistant • Manual dexterity and physical stamina are required • Acts as co-surgeon • Responsible for exposure and visualization of the wound

50. Why Surgical Technologists?