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Surgical Assistants

Surgical assistants range in training from fully licensed board-certified surgeons to high school students trained by the surgeon whom they assist. The appropriate training for a surgical assistant depends on the the assistant's role and the laws of the state. The liability for the surgeon and the hospital in allowing untrained or inappropriate surgical assistants is tremendous.

If the surgical assistant is expected to assist in cutting and sewing, he or she should be a licensed physician. If the assistant might have to take over the surgery, he or she must be a fully qualified and licensed surgeon. Complex surgery also requires a qualified surgeon as the surgical assistant. Procedures that involve equipment with special training requirements, such as endoscopic gall bladder removal, require an assistant who is qualified to use the equipment. If there is any possibility that the patient may have problems outside the surgeon's scope of practice, the assistant should be an appropriate specialty surgeon, unless such a surgeon is immediately available in the operating suite. A gynecologist who is not prepared to do bowel surgery should not discover that the suspected tubal abscess is actually an appendiceal abscess when there is no general surgeon available to take over. Surgery should not be started without adequate preparation and personnel to handle foreseeable complications.

Family practitioners should avoid acting as surgical assistants in situations in which they are not trained in the procedures to be carried out. If the patient is undergoing a simple procedure and the family physician could take over in an emergency, the family physician may be an appropriate assistant. If the family physician simply wishes to observe a major surgery, then he or she should not be the primary assistant.

Hospitals should monitor and credential surgical assistants just as they do all other professional personnel. A surgical assistant should be at least a licensed registered nurse. There is little justification for allowing persons without proper medical training and licensure to assist in surgery. Under no circumstances should unlicensed physicians be allowed to act as surgical assistants. Most boards of medical examiners view such practices as an attempt to circumvent the licensing laws. If a physician is needed, it must be a licensed physician.

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