Hands-on with the equipment
The team ran a training session for nurses at St Andrew's War Memorial Hospital. Attendees had hands-on practice with the implants and equipment used in shoulder surgery, which is intricate and continues to develop.
Handling the instruments and implants outside theatre, without a patient waiting, is the only practical way to become familiar with them. It makes a difference on the day.
What the theatre team does during shoulder surgery
An operation is not performed by a surgeon alone. The scrub nurse works at the table, anticipating which instrument is needed next and passing it, and keeps track of everything that goes in and out of the field. The circulating nurse works outside the sterile field, opening implants as they are called for, managing the equipment and the counts, and solving whatever is not where it should be. An anaesthetist and anaesthetic nurse manage the patient throughout.
Shoulder surgery makes particular demands on that team. Much of it is arthroscopic, which means the camera, light source, fluid pump, shaver and radiofrequency equipment all have to be running correctly before anything useful can be seen, and a fault in any of them stops the operation. The implants are small and come as systems of anchors, sutures, guides and inserters that have to be assembled in the right order.
Why equipment familiarity matters
A theatre team that knows the set in front of them can have the next item ready before it is asked for, and can recognise when a piece of equipment is not behaving as it should. That keeps the operation moving and keeps the number of interruptions down, which matters in a field where the time the joint is open and the number of people moving through the theatre both have a bearing on the risk of infection.
Shoulder implant systems also change regularly as designs are revised, so familiarity is not something a team acquires once. Running sessions of this kind with the instruments on a bench, rather than learning a new system for the first time during a case, is how that is kept current. Individual results vary.
With thanks to Grace Strudwick and to Arthrex for their support, and to Ridzwan Namazie, Rohit Sane and Christopher Child. Thanks also to QUASR and the ARC Training Centre for Joint Biomechanics at QUT and The University of Queensland.
Related information
- Our post on the Saturday training and education session.
- Our post on the training session at St Andrew's.
- The shoulder surgery page.
- The rotator cuff repair page.