General Surgery
General Surgery is the foundation of operative care and the specialty where most CSTs begin building their core skills. It includes abdominal, gastrointestinal, breast, endocrine, and soft‑tissue procedures performed in every hospital. CSTs in General Surgery support high‑volume cases ranging from appendectomies and hernia repairs to complex oncologic resections. This specialty requires strong fundamentals in sterile technique, instrumentation, anatomy, and efficient OR workflow.
Role of CSTs
- Prepare general surgery instrument sets, laparoscopic equipment, and specialty trays for abdominal and soft‑tissue procedures.
- Assist with patient positioning, prepping, and draping for open and minimally invasive cases.
- Maintain sterile technique during high‑volume, fast‑turnover procedures.
- Anticipate surgeon needs during dissection, exposure, hemostasis, and closure.
- Manage laparoscopic towers, insufflation systems, and energy devices.
- Handle specimen collection, labeling, and communication with pathology.
- Support emergency general surgery cases such as perforations, obstructions, and acute abdomen.
- Assist with accurate counts, instrument tracking, and efficient room turnover.
Essential Skills
- Strong understanding of abdominal and soft‑tissue anatomy.
- Proficiency with basic, laparoscopic, and energy‑based instruments.
- Ability to anticipate surgeon needs during dissection and exposure.
- Skilled in setting up and troubleshooting laparoscopic towers and insufflation.
- Competence with suturing, stapling, and specimen handling workflows.
- Ability to maintain sterile technique during rapid case turnover.
- Effective communication with surgeons, anesthesia, and nursing teams.
- Adaptability for both routine and emergent general surgery case.
Common Procedures
- Appendectomy (open and laparoscopic)
- Cholecystectomy (open and laparoscopic)
- Hernia repair (inguinal, umbilical, ventral, robotic)
- Bowel resection and anastomosis
- Colectomy and small bowel surgery
- Breast lumpectomy and mastectomy
- Thyroidectomy and parathyroidectomy
- Hemorrhoidectomy and anorectal procedures
- Exploratory laparotomy
- Abscess incision and drainage
- Soft‑tissue mass excision
- Feeding tube placement (PEG, open G‑tube)
Instruments & Equipment
Instruments
- Basic general surgery sets (major, minor, laparotomy)
- Laparoscopic instruments (grasps, scissors, dissectors)
- Trocars and insufflation equipment
- Retractors (Richardson, Deaver, Army‑Navy, Bookwalter)
- Bowel clamps and stapling devices
- Hemostatic instruments and ligature tools
- Needle holders, forceps, and suture instruments
- Specimen retrieval bags and biopsy tools
- Energy devices (LigaSure, Harmonic, monopolar, bipolar)
Equipment
- Laparoscopic towers and monitors
- Insufflation units and tubing
- Electrosurgical generators
- Suction and irrigation systems
- Positioning devices for supine and lithotomy cases
- Warming devices and fluid warmers
- Smoke evacuation systems
- Stapling and energy platforms
- Portable ultrasound (for vascular access or gallbladder evaluation)
Workflow & Case Progress
- Room setup with general surgery instruments, laparoscopic equipment, and energy devices.
- Patient positioning, prepping, and draping based on open or laparoscopic approach.
- Initial access using trocars or open incision.
- Exposure and dissection using retractors or laparoscopic instruments.
- Identification and treatment of pathology (resection, repair, removal).
- Hemostasis and specimen retrieval.
- Closure of incisions or trocar sites.
- Final counts, dressing application, and room turnover.
- Transfer to PACU with appropriate handoff.
Sterile Technique Considerations
- Maintain sterility during rapid turnover and high‑volume workflows.
- Protect the sterile field during laparoscopic tower adjustments.
- Handle contaminated bowel or infected tissue with isolation technique.
- Maintain sterile technique during specimen handling and labeling.
- Manage multiple instrument trays efficiently without contamination.
- Ensure sterile technique during emergency conversions from laparoscopic to open.
Career Pathways
- General Surgery Technologist
- Laparoscopic Specialist
- Robotic General Surgery Technologist
- Emergency General Surgery OR Specialist
- General Surgery First Assist (with additional training)
- Clinical educator for general surgery instrumentation
- Device representative for stapling and energy platforms
- Endoscopy technologist (in facilities where CSTs support GI procedures)
How to Prepare
- Study abdominal anatomy, organ systems, and common pathologies.
- Learn laparoscopic instrument names, functions, and troubleshooting.
- Practice handling staplers, energy devices, and specimen retrieval tools.
- Review open and laparoscopic workflows for common general surgery cases.
- Observe high‑volume general surgery cases to understand pacing and efficiency.
- Strengthen sterile technique for rapid turnover environments.
- Build familiarity with emergency general surgery procedures.