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Inside the surgical suite

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For many of us, our knowledge of what happens in an operating room may come from medical dramas on TV. But what really happens in the surgical suite after the patient is anesthesized?

This week on “Take Care,” Dr. David Hoyt, executive director of the American College of Surgeons takes us inside the surgical suite. Hoyt is also Professor Emeritus of surgery at the University of California, Irvine.

For those of us who have had surgery, we remember what happens beforehand. In the pre-op area, the patient meets the surgeon, nurses and anesthesiologist who will be involved in the procedure, and then says goodbye to their loved ones.

The patient gets wheeled in to the operating room and transferred to the operating table. The anesthesiologist gets to work and the patient goes to sleep.

The first step in a surgery after that is a very important event, says Hoyt. It’s a concept borrowed from the airline or space industry, which Hoyt says is called “crew resource management.”

Hoyt says the entire surgical team stops for a moment and runs a checklist to confirm what is going to happen. Who is the patient? What procedure is about to happen? Is any special equipment that is needed present? Each member of the team makes sure they know each other and what their role is.

Hoyt says the basic personnel who participate in any surgery include: the surgeon, the anesthesiologist, and two nurses. The first nurse is often referred to as the “scrub nurse,” and is the one most directly assisting the surgeon, handing him equipment. Hoyt says the second nurse is a backup and can also get any equipment or personnel that’s needed during the surgery, or provide any other needed tasks.

Other medical personnel who might enter the surgical suite during the procedure, according to Hoyt could include a radiology technician if an x-ray or other kind of scan is needed; or a pathology carrier, if something that is removed needs to go to the lab for testing.

If you’re wondering what the mood is during a surgery, Hoyt says that it is generally all business to start with – particularly during that crew resource management time out at the beginning. Once things get underway, the procedure becomes more routine, and surgeons may even play background music. During the closing up of the patient is probably when the medical team is most relaxed, says Hoyt, and conversations may become freer.

But overall, Hoyt says the surgical suite is a very professional, respectful environment.

Once the surgery is over, and the patient is taken to post-op, the turnover crew gets to work. They clean the opearting room to get it ready for the next surgery. Hoyt says a typical turnover time is 30-40 minutes between surgeries.