OBGYN Surgery

OBGYN Surgery

OBGYN Surgery includes operative care for the female reproductive system, covering gynecologic, obstetric, laparoscopic, and pelvic procedures. CSTs in this specialty support high‑volume cases such as hysterectomies, C‑sections, pelvic floor repairs, and minimally invasive gynecologic surgeries. This specialty requires strong knowledge of pelvic anatomy, laparoscopic workflows, and the ability to work efficiently in both scheduled and emergent settings, including labor and delivery.

Role of CSTs

  • Prepare gynecologic and obstetric instrument sets, laparoscopic equipment, and specialty trays for pelvic procedures.
  • Assist with patient positioning, prepping, and draping for abdominal, vaginal, and laparoscopic approaches.
  • Maintain sterile technique during high‑volume OBGYN and L&D procedures.
  • Anticipate surgeon needs during dissection, exposure, uterine manipulation, and closure.
  • Manage laparoscopic towers, insufflation systems, and energy devices used in minimally invasive gynecologic surgery.
  • Support emergency procedures such as C‑sections, ectopic pregnancy surgery, and postpartum hemorrhage control.
  • Handle specimens including ovarian cysts, uterine tissue, and biopsies with proper labeling and communication.
  • Assist with accurate counts, instrument tracking, and rapid room turnover in L&D and gynecologic ORs.

Essential Skills

  • Strong understanding of pelvic and reproductive anatomy.
  • Proficiency with laparoscopic instruments, uterine manipulators, and vaginal surgery tools.
  • Ability to anticipate surgeon needs during hysterectomy, C‑section, and pelvic floor procedures.
  • Skilled in setting up and troubleshooting laparoscopic towers and insufflation.
  • Competence with suturing, stapling, and specimen handling workflows.
  • Ability to maintain sterile technique during emergent obstetric procedures.
  • Effective communication with surgeons, anesthesia, L&D nurses, and midwives.
  • Adaptability for both scheduled gynecologic cases and rapid obstetric emergencies.

Common Procedures

  • Cesarean section (C‑se20ction)
  • Total abdominal hysterectomy (TAH)
  • Laparoscopic hysterectomy (TLH, LAVH)
  • Myomectomy
  • Ovarian cystectomy
  • Ectopic pregnancy surgery
  • Dilation and curettage (D&C)
  • Endometrial ablation
  • Pelvic organ prolapse repair
  • Tubal ligation (open, laparoscopic)
  • Hysteroscopy procedures
  • Vulvar and cervical procedures (LEEP, biopsies)

Instruments & Equipment

Instruments

  • Basic gynecologic sets (vaginal, abdominal, laparoscopic)
  • Uterine manipulators and dilators
  • Laparoscopic instruments (grasps, scissors, dissectors)
  • Trocars and insufflation equipment
  • Retractors (O’Sullivan‑O’Connor, Deaver, Richardson)
  • D&C instruments (curettes, tenaculums)
  • Myomectomy and hysterectomy specialty tools
  • Hysteroscopy instruments and scopes
  • Energy devices (LigaSure, Harmonic, monopolar, bipolar)

Equipment

  • Laparoscopic towers and monitors
  • Insufflation units and tubing
  • Electrosurgical generators
  • Suction and irrigation systems
  • Fetal monitoring equipment (in L&D ORs)
  • Warming devices and fluid warmers
  • Hysteroscopy towers and fluid management systems
  • Positioning devices for lithotomy and supine cases
  • Smoke evacuation systems

Workflow & Case Progress

  1. Room setup with gynecologic instruments, laparoscopic equipment, and energy devices.
  2. Patient positioning in lithotomy or supine depending on the procedure.
  3. Prepping and draping with attention to abdominal and pelvic access.
  4. Initial access using trocars, vaginal retractors, or abdominal incision.
  5. Exposure and dissection using retractors or laparoscopic instruments.
  6. Treatment of pathology (removal, repair, excision, or delivery).
  7. Hemostasis and specimen retrieval.
  8. Closure of incisions or trocar sites.
  9. Final counts, dressing application, and room turnover.
  10. Transfer to PACU or L&D recovery with appropriate handoff.

Sterile Technique Considerations

  • Maintain sterility during rapid turnover in L&D and gynecologic ORs.
  • Protect the sterile field during laparoscopic tower adjustments.
  • Handle contaminated or infected tissue with isolation technique.
  • Maintain sterile technique during emergent C‑sections and postpartum hemorrhage cases.
  • Manage multiple instrument trays efficiently without contamination.
  • Ensure sterile technique during conversions from laparoscopic to open surgery.

Career Pathways

  • OBGYN Surgical Technologist
  • Labor & Delivery OR Specialist
  • Minimally Invasive Gynecologic Surgery Technologist
  • Robotic Gynecologic Surgery Technologist
  • OBGYN First Assist (with additional training)
  • Clinical educator for gynecologic and obstetric instrumentation
  • Device representative for women’s health surgical platforms
  • Hysteroscopy or laparoscopic specialist

How to Prepare

  • Study pelvic anatomy, reproductive organs, and common gynecologic pathologies.
  • Learn laparoscopic instrument names, functions, and troubleshooting.
  • Practice handling uterine manipulators, retractors, and D&C instruments.
  • Review workflows for hysterectomy, C‑section, and pelvic floor procedures.
  • Observe OBGYN cases to understand pacing and emergency transitions.
  • Strengthen sterile technique for high‑volume, rapid‑turnover environments.
  • Build familiarity with hysteroscopy and minimally invasive gynecologic surgery.