MedAssist — Urology Services
A comprehensive, tiered support model for urologic ORs:
Third Assist®,
Scrub Assist (CST), and
Surg Assist (First Assist/Bedside support, including Robotics).
MedAssist delivers the right‑level surgical support tailored to urology, improving case flow, safety, and OR efficiency across laser BPH procedures (e.g., HoLEP), endoscopic cases, and robotic urologic surgery (e.g., prostatectomy). Roles and competencies align with national standards for surgical technologists (CST) and surgical first assistants (CSFA), and incorporate laser safety and robotic bedside best practices.
Service Overview
Third Assist®
(Non‑Sterile) — Urology
Value: Keeps sterile team focused by owning all non‑sterile logistics and device operation support, especially in laser and endoscopic workflows.
Scope Highlights:
- Operate and assist with laser
system setup under facility policies and Laser Safety Officer oversight (e.g., eyewear, signage, plume mitigation, “time‑out” checks for laser)
- Pull disposables
and specialty urology items per preference cards (e.g., laser fibers, sheaths, tip protectors, clips, baskets, stents) and stage case carts; replenish post‑case
- Manage
non‑sterile equipment: consoles, irrigation pumps, morcellator towers (per HoLEP workflow), camera/light sources; verify settings intra‑case as directed by RN/MD
- Coordinate
instrument turnover
with SPD and circulating RN; support room turnover and OR traffic patterns for efficiency and safety
Exclusions:
No sterile scrubbing or intra‑operative tissue handling; no independent laser treatment; follows ANSI Z136.3 and facility policy.
Scrub Assist
(CST Back Table)
— Urology
Value: A certified surgical technologist dedicated to urology sets the field for speed and sterility; anticipates instruments for endoscopic, open, and robotic‑assisted urology.
Scope Highlights:
- Pre‑op sterile setup:
surgical scrub; gown/glove; back table & Mayo stand; initial counts; draping; secure cords/tubing; universal protocol/time‑out participation
- Intra‑op sterile support:
pass instruments/implants; maintain sterile field; suction/irrigation; hemostasis adjuncts; cut suture; specimen handling; additional counts; dressings; terminal clean/turnover
- Urology specifics:
endoscopic lens management, sheath/obturator workflows, laser fiber handling & verification with sterile adapters, morcellation support, and camera operations during laparoscopic/robotic cases (as directed)
Credentials:
CST (NBSTSA certification) with continuing education compliance; scope and competencies per AST/ACS standards.
Surg Assist
(First Assist / Bedside — including Robotics)
Scope Highlights:
- Pre‑op: position patient (lithotomy/Trendelenburg per case), assist with trocar placement, and ensure robotic instrument readiness and preference‑based setup
- Intra‑op (open/lap/robotic): provide exposure/retraction; manage suction/irrigation; achieve hemostasis (clips/cautery); suture/ligate; specimen retrieval; safely introduce/remove robotic instruments; monitor insufflation and intra‑abdominal pressure as directed by surgeon/anesthesia; suture and close per privileges
- Robotics (da Vinci): support docking, instrument exchanges, camera optimization, collision troubleshooting, and bedside tasks not feasible at the console (e.g., stapling, large‑volume suction)
- Post‑op:
undock robot; remove trocars; close ports (fascial closure as indicated); apply dressings; handoff documentation of intra‑op events
Credentials: CSFA/SA‑C or surgeon‑privileged assistant; role defined by AST/ACS/CAAHEP standards; first assistant provides primary intra‑operative assistance (distinct from scrub tech).