Setup for an Open Pancreatectomy (Eastwick College, Ramsey, NJ)

Open pancreatectomy is a complex, high-risk abdominal surgical procedure. The surgical technologist must prepare carefully for this procedure to ensure proper instrument setup, sterility, and accurate surgical counts. The setup demonstrated in this educational video can serve as a model for surgical technology students and others interested in learning an efficient way to prepare the sterile field.

Pancreatectomy, the partial or total resection of the pancreas, is among the most technically demanding procedures in abdominal surgery.^1,2 It is performed for conditions including benign and malignant pancreatic neoplasms, chronic pancreatitis, and pancreatic trauma, with total pancreatectomy reserved for cases where partial resection is insufficient.^3,4 The complexity of the operation demands surgical expertise and highly competent perioperative support.

The surgical technologist is responsible for maintaining the sterile field, organizing instrumentation, and facilitating efficient intraoperative workflow. Standardized setup procedures have been linked to reductions in retained surgical items (RSIs), surgical site infections, and operative delays.^5–7

The sterile field is initiated by double draping the back table and Mayo stand. Blades are secured within a designated sharps container; sterile saline and medications are received onto the sterile field in collaboration with the circulating nurse. The surgical technologist must confirm each medication or liquid’s name, strength, and expiration date with the circulator and label containers (syringes, bowls, medication cups) right away.

One side of the sterilely-draped double ring basin holds the gowns, gloves, and towels for the surgical team, as well as four adhesive towels (used for squaring off the incision site) and patient drapes, placed in order of use. The other side of the ring basin is stocked with extra towels, a light handle cover, a skin prep stick, and suction tubing.

The circulator and surgical technologist must verify that each instrument container is free of contamination before its contents may be placed on the sterile field. Prior to opening, each container is inspected for absence of moisture and strike-through contamination. Once opened, the internal chemical indicator is retrieved and checked by both people to verify that it met the critical parameters of the sterilization process. The count sheet is then handed off to the circulator and the surgical technologist can transfer the instruments to the sterile field. This process reflects the requirement that sterility indicators be verified by two individuals before instruments are accepted onto the field.

Once on the sterile field, the instrument tray is inspected beneath the blue mesh liner for hidden instruments or residual moisture before setup begins. Forceps and retractors are arranged by type. Individual setup preferences vary between practitioners. Here, instruments are grouped by function and anticipated sequence of use to ensure a smooth intraoperative workflow. The initial count is conducted with the circulating nurse, who documents the number of each item on the count sheet. Typically, surgical counts follow this order: sponges, sharps, then instrumentation. Following completion of the initial count, the surgical technologist loads the Mayo stand with supplies and instruments that will be used at the beginning of the case.

The framework described here is relevant to surgical technology students, early career surgical technologists,, and perioperative educators. The goal is to provide a sterile setup that supports positive surgical outcomes, efficient workflows, and patient safety.

Nothing to disclose.