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Introduction to Surgical Technology & History of Surgery
ST210Concorde Career College
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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
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History
Refer to Table 1-1 Pages 4-5 (ST4ST)
•Ancient Times•Dark Ages•Renaissance•Classical Period•Modern Age
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Ancient Times4,000 BC
Cuneiform Script
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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
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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
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Ancient Times• Moses
▫ Circa 2000 BC▫ Established laws for
cleanliness• Caduceus
▫ Numbers 21:4-9
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Ancient Times• Circa 1500
▫ Ebers Papyrus▫ Egyptian Medical
hieroglyphs▫ Hindu Vedas
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Ancient Times• Circa 1,000 BC
▫ Homer Early Greek historian
and mythologist Described military
medicine▫ Susruta
Father of Indian medicine
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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
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Classical Period
• Aristotle▫ 384 – 322 BC▫ Established early
scientific mindset▫ Founder of comparative
anatomy
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Classical Period• Herophilos
▫ 335 – 380 BC▫ Father of Anatomy▫ First to describe the
pulse as a diagnostic tool/vital sign
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Classical Period• Aulus Cornelius Celsus
▫ 25 BC – 50AD ▫ Greek Encyclopaedist ▫ First to describe the
cardinal signs of inflammation
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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
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Dark Ages (500 AD – 1100 AD)
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Dark Ages• Avicenna
▫ 980 – 1037 AD▫ Persian philosopher▫ Wrote The Canon of
Medicine▫ Revived Aristotle’s
theories
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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
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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
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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
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Vesalius
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Renaissance• William Harvey
▫ 1578 – 1657▫ First to accurately
describe circulatory anatomy and physiology
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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
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Modern Age• Louis Pasteur
▫ 1822 – 1895 AD▫ French chemist and
microbiologist ▫ Father of Microbiology
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Modern Age• Joseph Lister
▫ 1827 – 1912 AD▫ Father of Asepsis▫ Used carbolic acid to
cleanse wounds and sterilize surgical instruments
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Modern Age• William S. Halsted
▫ 1852 – 1922▫ Developed techniques for
meticulous wound closure
▫ Halsted’s Principles of Tissue Handling
▫ Developed sterile surgical gloves
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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
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Modern Age• Denton Cooley
▫ Born 1920▫ Perfected the heart-lung
machine▫ Performed first US heart
transplant▫ Implanted first total
artificial heart
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What differences do you see?
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History
Once these three principles were identified and solutions found – modern medicine
could emerge!
1. Infection
2. Pain
3. Hemorrhage
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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?
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History
Reasons for Surgical Intervention
•Trauma•Disease•Condition•Congenital Anomaly•Desire
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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)
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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)
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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)
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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
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PPEOR PreparationSterile field (creating, organizing, maintaining)OrganizingAssisting with gowning and glovingDraping
PREOPERATIVE CASE PREOPERATIVE CASE MANAGEMENTMANAGEMENT
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Maintain the sterile fieldHandling of instruments, supplies, etc.Preparing medicationsCountingProper specimen identification and labelingDressing application
INTRAOPERATIVE CASE INTRAOPERATIVE CASE MANAGEMENTMANAGEMENT
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Maintain the sterile field until the patient is out of the roomDisassemble the sterile fieldPatient transportationRoom turnover
POSTOPERATIVE CASE POSTOPERATIVE CASE MANAGEMENTMANAGEMENT
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Surgical Team Members
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NON-STERILE SURGICAL NON-STERILE SURGICAL TEAM MEMBERSTEAM MEMBERS
Circulator (RN, LPN, or Surgical Technologist)Anesthesia ProviderRadiology TechnologistPathologySurgical ObserversAnyone outside of the sterile field
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Preparing the ORConducting pre-op patient interviewTransporting to and from the OR (Pre-op, PACU)Transporting the pt. to and from the OR tablePositioningPrepping the skinAssist with drapingAssist anesthesiaCounting, gathering suppliesVarious cord hook-upsMaintaining the OR recordSpecimensDressings
CIRCULATING DUTIESCIRCULATING DUTIES
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Non-sterile Team Members
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ANESTHESIA PROVIDER ANESTHESIA PROVIDER RESPONSIBILITIESRESPONSIBILITIES
MD, DO, CRNAPt. assessmentDetermining type of anesthesiaDiscussing the risks of anesthesiaMonitoring vital signsProviding supportive measures (airway, fluids)
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STERILE TEAM MEMBERSSTERILE TEAM MEMBERS
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WHO ARE THEY?WHO ARE THEY?
Surgical TechnologistSurgeon
MD, DO, DPM, DDS, DMD
Surgical AssistantCSFA, CSA, SA-C, CRNFA or RNFA, PA-C, OT-C or OPA-C, surgical resident, or other surgeonCST (limited scope)
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The SurgeonThe Surgeon
•Assumes full responsibility for all medical acts of judgment and management of the surgical patient
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Surgical First Assistant
Manual dexterity Manual dexterity and physical and physical stamina are stamina are requiredrequired
Acts as co-Acts as co-surgeonsurgeon
Responsible for Responsible for exposure and exposure and visualization of visualization of the woundthe wound
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Why Surgical Technologists?
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Personal Characteristics
•Ability to multi-task•Neat, accurate•Ability to stay focused in any situation•Stable temperament, patience•Manual dexterity, physical stamina•Ability to anticipate “what comes next”
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Working Conditions
• Brightly lit, quiet, temperature controlled OR• Standing for long periods of time• Lifting heavy objects• Concentration• Unpleasant sites, odors, hazardous
materials, communicable diseases• 40 hour work-week plus “call rotation”
nights, holidays, and weekends