Concorde Career College, Department of Surgical Technology
ST210
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Define the term computer
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List and describe the basic components of a
computer system
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Understand basic word processing and the
use of graphics
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Access the internet to gather information
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Apply basic computer skills to the
educational process and to surgical case
management
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Demonstrate knowledge of terminology
related to computer skills verbally and in the
written form
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Scheduling
Send/Receive Orders
Send/Receive Medical
Records
Update Pt. Chart
Insurance Billing
Update Surgeon’s
Preference Card
Manage and Print
Instrument Count Sheets
Order Supplies
Complete Operative
Record
Laboratory Requisitions
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Surgical patient
scheduling software
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Preference Card
Applications
 As opposed to…
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…Hand written
 Often illegible
 Difficult to find
 Easily lost
 Can be taken with the
surgeon to another
facility
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Order Supplies and
Instruments
Maintain Inventory Par
Levels
Save and Manage
Sterilization Records
Create Instrument Tray
Menu Cards
Interdepartmental
Equipment Transfers
Track Equipment
Maintenance
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Supply chain
maintenance and
ordering software
The use of robotics in the OR
is gaining in popularity
among many surgical
specialties
 Integrates complex computer
science and mechanics
 STs are often required to
maintain, manage, sterilize,
and manipulate this
equipment
 Must understand basic
computer concepts in order
to successfully function in the
robotics-integrated OR suite
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Watch the following basic computer
hardware tutorial:
 http://www.youtube.com/watch?v=-
FnnGouYpQQ
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Programs that operate
the computer system
and its individual
hardware components
 Operating systems
 Word processing
 Email
 Internet
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Global network connected through millions
of servers
World Wide Web (www) is the most recent
format for the Internet
Photo and Article Access
 Each has address begins http://www.
 Not all Web addresses contain www
 Ending of address identifies what type
organization publishes the information (.org, .gov,
.edu, etc.)
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Search Engine
 Popular Search
Engines
▪ Google, Bing,
Yahoo
 Uses keyword or
phrases to search
for subject
 Usually first 20 – 30
articles directly
pertain to subject
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Research for Homework and Projects
 Avoid using sites like Wikipedia that are not peer
reviewed, professional data sources
 Prefer scholastic search engines to general search
engines
▪
▪
▪
▪
▪
Google Scholar: http://scholar.google.com/
iSeek: http://education.iseek.com/iseek/home.page
Library of Congress: http://www.loc.gov/index.html
Google Books: http://books.google.com/
Science.gov: http://www.science.gov/
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AST Website & Discussion Board
 http://www.ast.org/
 Visit the state assembly
▪ http://www.ast.org/state_assemblies/index.aspx
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Define the term electricity.
Understand the basic principles of electricity.
List and describe the types of electrical
current.
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List and describe the basic components of an
electrical receptacle.
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Analyze the relationship between magnetism
and electricity.
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Identify basic electrical equipment utilized in
the surgical environment.
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Apply knowledge of electricity to safe
practice in the surgical environment.
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Demonstrate knowledge of terminology
related to electricity verbally and in the
written form.
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Electrosurgery
X-ray
Endoscopes
Lasers
Robotics
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Matter is anything that has mass
and occupies space
 All matter consists of atoms
 Volume is the amount of space
occupied by an object.
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Atoms are composed of small
particles:
 Protons
 Neutrons
 Electrons
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Protons – Inside nucleus and
positively charged
Neutrons – Inside nucleus; neutral
particles
Electrons – Revolve around the
nucleus; negatively charged particles
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Electrons revolve around the nucleus in paths
called shells or orbits
Electrons that are located closer to the
nucleus demonstrate a stronger attraction
the nucleus; electrons moving in the outer
orbits are less attracted.
In certain atoms, if these outer electrons are
exposed to light, heat, or electric energy,
they will speed up and leave the atom
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These outer electrons are known as free
electrons
The movement of free electrons creates
electric current
The term electricity describes the free
electrons moving or flowing from the ring of
one atom to another
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Materials that allow the flow of free electrons
Examples: silver, iron, saltwater, copper
Copper is the commonly used because it’s the
most economical
Examples of OR devices that use copper: OR
lights, power drills, ESU
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Because water is a conductor of electricity,
the amount of humidity in the air is important
High humidity often results in static charge
leakage
Low humidity results in the formation of
sparks
Humidity in the OR is maintained between
50% and 55%
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Materials that inhibit the flow of free electrons
Insulators are simply poor conductors
Conductors are wrapped in insulation to
prevent leakage of electrons while the
current flows to the device that will use it.
Examples of insulators in the OR are the
plastic and rubber casings that cover the ESU
cords
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Can be either negative or positive.
Like charges repel each other, unlike charges
attract each other.
 2 negative charges or 2 positive charges will repel
each other.
▪ ***Opposites attract***
▪ (magnets)
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Electric current is movement of the electrical
charge
The electrical current travels through
conductors by movement of the free electrons
that migrate from atom to atom inside the
conductor
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Electrical potential
 Voltage: The force or push that moves free
electrons from one atom to another.
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Restricting the flow of the current
 Measured in ohms
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Opposing or counteracting force
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Power – the rate at which work is done (exbattery)
 Power is measured in watts (W)
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Load – the device that uses the energy (exflashlight bulb)
Switch – device that opens or closes a circuit
and controls the flow of electricity (exbetween the battery and flashlight)
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Hot Wire: supplies electrical current in a
circuit TO a device.
Neutral Wire: AKA ground wire, carries
electrical current in a circuit AWAY from a
device.
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Plugs used in surgery have 3 prongs.
 Components:
▪ First prong (positive)
▪ Second prong (negative)
▪ Third prong (ground)
 If electrical short occurs, the electrical current will
flow through the grounded plug to reduce the risk
of current passing through surgical team or
patient. Must never be removed to fit in a 2 prong
plug.
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Direct (DC): electrical current that flows in
one direction.
 Batteries
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Alternating (AC): electrical current that
reverses direction periodically. A complete
cycle moves in one direction and then
reverses its course.
 Electrosurgery
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Generator (power source)
Active electrode (electrosurgical pencil)
 Delivers the electric current to the surgical site
through the tissue, the energy is converted from
electrical to thermal.
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Patient
Dispersive electrode/inactive electrode
(grounding pad)
 Electric current is channeled back to the
generator via the grounding pad
 Placing the grounding pad p 112
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Monopolar
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Bipolar
 Most common
 Less frequent
 Coagulation or cutting, or
 Only coagulation
blend
 Large areas
 Grounding pad needed
 Delicate procedures
 Areas of moisture
 Grounding pad not needed
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Harmonic scalpel
 Ultrasonic energy
 Cut and coagulate
 Surrounding tissue suffers less thermal damage
(charring)
 A grounding pad is not necessary
▪ No electricity
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Reduced blood loss
Saves time
Cutting current also burns tissue reducing the
need to stop and control bleeding
Cutting current seals small spaces in the
tissue and lymphatic vessels
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Electrical burns
 Patient and surgical team
▪ Resonant frequency (RF) capacitive coupling: AC travels
from active electrode, across insulation and into skin.
▪ EX: surgeon clamps hemostat to bleeding vessel
▪ Dielectric Breakdown: occurs when high voltage breaks
down insulating material (gloves) causing a hole and
possibly burning the individual.
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Different from ordinary light
Monochromatic
Coherent
Collimated
Its color will decide how it will react with
various tissues
 Red laser light is absorbed by red-pigmented
tissue
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Photon: a particle of LASER light energy
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Fluence
 Spot size, watts, time
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Four interactions of laser with tissue
 Absorption, transmission. reflection, or scattering
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Energy pump (excitation source) responsible for
delivering the energy to the laser head to produce laser
light - can be from any energy form (media)
Laser head – active medium that produces the laser
energy. Lasers are named according to active medium.
Mirrors are positioned at both ends of laser head. Laser
energy is reflected off mirrors.
Ancillary components – includes the console, cooling
system and vacuum pump
Control panel – controls for operating the system;
includes wattage, duration, and mode
Delivery system – transports the laser energy from the
laser head to the tissue. Ex – articulated arm, fiber, fixed
optical array
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Carbon Dioxide
Argon
Nd:YAG
Holmium: YAG
**YAG=pulsed beam
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Most frequently used
Invisible beam
 Helium-neon laser beam is transmitted with the Co2
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laser to aid in aiming (red color)
Permits precise cutting and coagulating
Absorbed by cellular water content (not dependent on
tissue color or consistency)
Not effective for use where the laser light needs to be
transmitted through clear fluids.
Delivered through an articulated arm w/ mirrors
positioned at the articulations.
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Laser Bronchoscopy
Dermatologic
 Pigmented lesions
 Shallow Tumors
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GYN
 HPV
 BX for abnormal PAP
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Produces a blue or green light
Plasma tube that contains argon
 $$$
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Laser energy is converted to heat when
absorbed, produces coagulation and
vaporization.
Can travel through clear fluids and tissues,
absorbed in tissue by hemoglobin or melanin.
Used in treatment for the eye
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Eyes
 Bleeding vessels
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Consists of crystal laced with neodymium.
Invisible beam: requires helium-neon laser
aiming beam
Absorbed by darker tissue
Can be transmitted through clear fluids.
Used to vaporize bladder tumors
Delivered through non contact or contract
fiber delivery system.
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TURP
Urethral Strictures
Bladder Tumors
Hysteroscopy
 Uterine polyps
 fibroids
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Discharges a pulsed beam
Travels through flexible fiber
Can be transmitted through clear fluids
Used in arthroscopic procedures
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LASIK
Lithotripsy
 -Tripsy: crushing
 Lith/o:stone
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Gas: Co2 , Helium Neon, Krypton, Argon and
Excimer
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Solid: KTP and Nd:YAG. (Most power output)
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58
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Define the term robot.
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Provide a timeline of the events leading up to the
use of robots in the surgical environment.
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List the advantages and disadvantages to the use of
robots in the surgical environment.
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Describe the principles of geometry that
relate to robotics.
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Identify the basic components of the surgical
robot and describe the function of each.
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Describe the mechanisms by which the surgical
robot operates.
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Apply knowledge of robotics to safe practice in the
surgical environment.
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Demonstrate knowledge of terminology related to
robotics verbally and in the written form.
A robot is a machine designed to operate in
a seemingly human way, with speed and
precision. There are as many different
types of robots as there are tasks for
them to perform.
Robotics is a branch of engineering that
involves the conception, design,
manufacture, and operation of robots.
This field overlaps with electronics,
computer science, artificial intelligence,
mechatronics, nanotechnology, and
bioengineering.
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Improve surgical patient care
Overcome human limitations
Reliable
Complex
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First generation robots are simple machines
capable of performing precise repetitive
motions at high speeds.
First Generation Robot
No artificial
intelligence (AI)
 Require constant
oversight
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Second generation robots incorporate a level of
artificial intelligence.
Second Generation
Robot
Requires occasional
monitoring
 AI (computer chip)
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 Tactile sensors
 Auditory capabilities
 Visual abilities
Third generation robots are autonomous.
Third generation robot
Mars Rover Spirit
Works independently
(without supervision)
 Controlled by a
central computer
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Fourth generation robots are not yet
developed.
Fourth generation robot
Predicted to have
ability to:
 Learn
 Reproduce
 Evolve
Delta (Berlin, Germany)
Robotic Surgical
Microscope
Advantages
 Decreased hospital
stay/reduced overall
cost
 Reduced tremor
 Expert surgeon
available even if not in
geographic area
 Reduced risk of
transfer of disease
Disadvantages
 Initial cost of
equipment is great
 Actual operating time
may be increased
especially during
learning curve
 Technical difficulties
Study of figures in a space of a given number of
dimensions and of a given type.
René Descartes (1637) introduced the use of
coordinates for describing plane curves, the axes
were omitted, and only positive values of the x- and
the y-coordinates were considered, since they were
defined as distances between points. For an ellipse
this meant that, instead of the full picture which we
would plot nowadays, Descartes drew only the
upper half.
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Point
Ray or plane
X axis or plane (horizontal)
Y axis or plane (vertical)
Origin (intersection)
Angle
Z axis or plane (third dimension)
Slope
Curvilinear
Five Basic Components of the Surgical Robot
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Controller (Hermes)
Arm (AESOP – voice controlled)
Drive (Zeus – Motor)
End Effector (Instruments)
Sensor (AI)
Socrates – Telecommunication system
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NOTES
Anesthesia Robots
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Natural Orifice
Transluminal
Endoscopic Surgery
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Closed-loop anesthesia
systems
 McSleepy
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McSleepy meets
DaVinci
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Surgical technologists
will be responsible for:
 Setting up the robot
 Running the computer
programs
 Operating equipment
during the surgical
procedure
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