A Surgeon’s Perspective

From Dr. J. Sean Begley, MD, Attending Physician in Obstetrics and Gynecology, Citrus Valley Medical Center – Queen of the Valley

As the landscape for surgery and hospital administration continues to evolve, surgical technologists and assistants are becoming increasingly integral in the operating room (OR). They allow the surgeon to perform to the best of their ability and for the surgery to run smoothly. Without them, surgeons would struggle with every aspect of the case, from the initial incision to the last stitch.

Preparation and a Good Attitude Add Up

Good surgical technologists and assistants anticipate all aspects of surgery and facilitate getting the patient safely out of the operating room (OR). These skills come from experience and a fundamental understanding of what needs to be achieved, which is largely a didactic exercise. This is where preparation before even arriving at the hospital is key for a surgical technologist or assistant – through classes, careful study of textbooks, watching videos, and discussing cases with peers.

Having a good attitude and understanding surgery’s high-pressure nature is helpful, too. Surgeons can get frustrated by how the surgery is going and may come off as abrasive. However, if the surgical technologist or assistant knows to not take this personally, it will help their overall well-being and feelings about being in the OR. 

A strong surgical technologist or assistant is one who is familiar with the surgery, if not the surgeon themselves. Knowing ahead of time what the surgeon might need for the case, such as specific retractors or proper draping techniques, goes a long way to prevent unintended delays.

Once the case has started, surgical technologists and assistants must “read the field” to see how the surgeon operates, and adapt to their style. A thorough understanding of the case as it is described in textbooks also allows the surgical technologist or assistant to anticipate the surgeon’s next move. It reassures the surgeon that everyone is working as a team and paying attention.

Learning Is a Two-Way Street

Personally, I rely on surgical technologists to occasionally introduce to me newer instruments, medical devices or products they have used with other surgeons. Most surgical technologists and assistants see a greater variety of surgeries and surgical techniques than most practicing surgeons see. Sharing this knowledge freely not only helps me stay current, but helps the team take important steps to evolve, too.

I have worked with student surgical technologists and assistants and am impressed with their dedication and drive. While I usually defer to the proctoring surgical technologist to oversee the quality of the students’ work, I do give students input and encouragement. I remember what it was like to be new to the OR – it’s an intimidating place. Being able to handle the pressure is an accomplishment in itself.

Ask Questions and Show Enthusiasm

New students should ask questions, provided the time is right. Surgery has an ebb and flow. During parts that require strict focus from the surgeon, students should not ask questions. However, when that part passes or as the case wraps up, students should ask away. Enthusiasm for a subject is far more important than how “smart” someone is. If a student projects enthusiasm, the surgeon and the nurses are more likely to engage the student in elaborate discussion of their questions.

If there is one piece of advice I can impart to students, it is to be enthusiastic about the job. The job is not always interesting or exciting, but if the student maintains a thirst to improve and learn more about their role, they will feel rewarded. Their enthusiasm will project to others, including the patient, showing that the student should be there and can be an asset. 

Dr. J. Sean Begley earned his bachelor’s degree in biology from UCLA and his medical degree from the University of Southern California. Begley was an OB-GYN intern and resident at Los Angeles County – USC Women’s and Children’s Hospital. He completed a pelvic surgery fellowship at Virginia Mason Medical Center in Seattle. He later joined Kaiser Permanente Northern California and became a partner before moving back to Southern California. He then joined Citrus Valley Medical Center – Queen of the Valley campus, as an attending OB-GYN and continues to practice general and high risk obstetrics, as well as general gynecology and urogynecology.