Surgical First Assist Operating Room

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Description

We want to ensure your needs are met. We offer a variety of comprehensive medical, dental, and vision plans along with some unique benefits including

• Tuition Reimbursement/Assistance Programs

• Moving, mortgage, and real estate assistance

• 100% matching 401k based on years of service

• Identity Theft Protection discounts

• Auto, Home, and Life Insurance options

• Adoption Assistance

• Employee Stock Purchase Program (ESPP)

• Student Loan Repayment

Key features for OR and CVOR include:

• Largest robotic program nationwide with six da Vinci Xi HD Surgical Robots
• Intraoperative Magnetic Resonance Imaging Suite (IMRIS)
• Largest Deep Brain Stimulation (DBS) program in the country in a non-academic setting
• Largest neurosurgery and gynecology programs in South Texas
• Extensive breast reconstructive surgery program to include DIEP flaps and vascularized lymph node transfer
• Growing head and neck oncology surgical services
• Level III Trauma Center
• 22 state of the art OR suites  
• 4 state of the art CVOR suites, including a hybrid suite
• Servicing all of South Texas heart transplants
• ECMO program for adults and pediatrics
• Busy TAVR program
• Congenital heart program 

• Functions as a surgical first assistant at the direction of and under the appropriate supervision of the attending surgeon; always practices within the limitations of preparation and experience and within the scope allowed by the hospital.
• Consistently functions at the direction of and under direct supervision (physical presence of the  attending surgeon in the procedure/treatment room) of the attending surgeon. The surgical assistant scope includes:
• 1. Providing visualization of the operative site through appropriate placement and securing of retractors with or without padding, packing or sponges; digital manipulation of tissue; suctioning, irrigation or sponging; manipulation of suture materials; proper use of body mechanics to prevent obstruction of the surgeon’s view.
  2. Utilizing appropriate permanent and temporary techniques to assist with hemostasis.  Permanent hemostasis techniques include clamping and/or cauterizing vessels and tissue, tying and/or ligating clamped vessels or tissue, applying hemostatic clips, or placing hemostatic agents. Temporary hemostasis techniques include applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use; applying vessel loops, non-crushing clamps, or direct digital pressure.
  3. Administering post-operative subcutaneous local anesthetic injection 
  4. Utilizing running or interrupted sutures with absorbable or non-absorbable material of wound layers, including muscle and fascia.
  5. Assisting  with placement of implants
  6. Robotic procedures only: Insertion of subsequent (not initial) trocars. Must have documented training and competency validated (initially within by MHS Medical staff member privileged to perform robotic surgery.  The documentation must include directly supervised trocar insertions on a minimum of 5 patients completed within a 12 month period with good patient outcomes.
  7. Saphenous Vein Harvesting only: May harvest saphenous vein through endoscopic or open technique. Must have documented training and competency validated by a MHS Medical staff member privileged to perform Cardiothoracic surgery.  The documentation must include directly supervised saphenous vein harvests on a minimum of 10 patients completed within a 12 month period with good patient outcomes.

    B.  Under direct or  general perioperative supervision (surgeon/proceduralist presence in the perioperative  area (pre-op department, perioperative suite, PACU, OR/procedure waiting room) and is immediately available), the surgical assistant scope includes closure of body planes and applies wound dressings per the method indicated by the attending physician:

1. Utilizing sub-cuticular closure technique with or without adhesive skin closure strips
2. Skin closure with suture, staples and/or spray occlusive material/skin adhesive strips
3. Securing drainage systems to tissue
4. Application of immobilizing dressing

3. Consistently assists with maintaining the patient’s expected physiologic responses to surgery including infection prevention (SCIP measures and practices, maintaining effective disinfection practices, instrument processing, and sterilization).

       4. Demonstrates effective communication and works collaboratively with all members of the perioperative team to include active consistent participation in Universal Protocol and timely and accurate sponge and sharp counts to include initiating corrective action as appropriate.

     5. Consistently applies a working knowledge of patient pre-operative deficits, risk for intraoperative injuries, and possible post-operative outcomes to assist in optimal patient outcomes. Demonstrates principles of safe patient positioning for best exposure in collaboration with the surgical team using appropriate positioning equipment to ensure padded pressure points, protection from nerve damage and unimpaired circulation.

     6. Functions in the role of a Surgical Technician as needed by the department; however, does not concurrently perform as the surgical first assistant and surgical technologist. Wears proper surgical attire, opens sterile packs, instruments, and supplies for each procedure, scrubs, gowns, gloves, and drapes according to established aseptic technique and protocols. Monitors sterile field during procedure and takes appropriate measures to insure integrity of  sterile field and maintenance of sterile techniques.  Initiates corrective action for any break in technique.