6 - General intra–operative principles

Summary

For all its complexities and apparent mystique, surgery is a manual craft. Therefore, the simple rules of any manual craft apply. For example, avoid doing anything that might distract the surgeon. Do not allow instruments or any part of your body, to obscure the surgeon's view of the operation. Keep unnecessary movements of your hands and vocal cords to a minimum. In particular, do not play with the instruments. Some assistants have even been known to dance to music playing on the radio; few surgeons will fail to be annoyed by this.

Concentrate on your task

Although surgical operations require the surgeon and assistant to concentrate continuously, the intensity of this varies. For example, while it is common for the surgeon and other staff members (including yourself) to chat about unrelated matters during straightforward parts of the operation, do not allow yourself to become distracted even at these times. This situation may be likened to driving a car; although it is reasonable to carry on a conversation while driving on an easy stretch of road, it is inadvisable to take your hands off the steering wheel and stop watching the road while doing so. Similarly, most operations have ‘tricky bits’ at some point (see p. 33). This is perhaps analogous to driving a car on a slippery road on a dark foggy night; both situations require full concentration.

If you are ever assisting a surgeon who is dealing with a massive bleed, or some other difficult problem, you must strive to remain calm and put all distractions from your mind.