Assisting in Theatre

Every surgeon will need an assistant for nearly every procedure they perform, regardless of how many times they have performed it.

As a medical student or surgical trainee in theatre, you can be as crucial to the success of an operation as everyone else present in the operating room.

Following a few basic principles will allow you to maximise your time in theatres and make assisting in surgery a productive learning opportunity.

Before the Operation

Check the theatre list the day before you are due to be attending. Note down details of the procedure being performed and its indication.

Read up on the procedure being performed and the relevant anatomy; you will gain much more out of your time in theatre if you have a greater awareness about the operation are the structures involved.

If the patient is well, attempt to see the patient prior to surgery, taking a focused history and examination where possible.

During the Operation

When entering the operating theatre, introduce yourself to all theatre staff and make sure you are counted in the WHO checklist. If you are scrubbing into the operation, ask the scrub nurse for permission and guidance if needed.

Once scrubbed in, always be honest at your own level of ability. Whilst you may want to do as much as you can, undertaking tasks you are not competent with puts the patient at risk; remember, patient safety is always the priority.

During the operation, make sure you pay attention, listen, and keep your hands outside the view of the surgeon*. If you are not active within the operation, simply place your hands carefully on the patient, to reduce the risk of any contamination.

*If at any point you feel faint, just move away from the operating table, inform the theatre staff, and sit down

After the Operation

If there is time, speak to the surgeon following the operation, discussing what went well and what could have been improved

If feasible, visit the patient post-operatively to observe the impact the surgery has had on them.

Tips from the Experts

Professor Nick London (Consultant Vascular Surgeon, University Hospitals of Leicester)
“If you are assisting at an operation, always ask yourself the question “if I was doing this operation, how could the assistant best help me?””

Mr David Scott-Combes (Consultant Endocrine Surgeon, Past President of the British Society of Endocrine & Thyroid Surgeons)
“Interact – surgeons love to talk about their work, so ask questions and you will be rewarded with education and entertainment. When shown some piece of anatomy do not just nod your head because the surgeon won’t be looking at you – say something”

Miss Rhiannon Harries (Consultant General Surgeon, Past President of Association of Surgeons in Training)
“Always make sure you check the theatre list the day before and read up on the operations. Your boss is more likely to let you scrub in or perform in part if you show you have knowledge of the operation.”

Mr Ian Beckingham (Consultant General Surgeon, Past President of the Association of Upper GI Surgeons)
“Know the cases well – you will be asked three questions in each case; about the patient, about the operation, and about the anatomy. If you can answer these, you will be highly thought of and encouraged to participate.”

Ms Suzanne Biers (Consultant Urological Surgeon, Cambridge University Hospitals)
“Ask questions to show that you are interested and involved in the case, but ensure to time this carefully, e.g. not when the surgeon is dealing with active bleeding”