Certified Surgical Technologist Intraoperative Procedures 5 — Questions and Answers
Question 1: During a laparotomy, the scrub tech is asked to load a TA stapler. The TA stapler is used to:
- Simultaneously cut and staple across tissue in one firing
- Apply a double row of staples across tissue WITHOUT cutting (Correct answer)
- Anastomose two hollow viscera end-to-end
- Close the skin in a subcuticular fashion
Correct answer: Apply a double row of staples across tissue WITHOUT cutting
The TA (thoracoabdominal) stapler applies two staggered rows of staples across tissue without a built-in cutting blade, requiring the surgeon to cut separately.
Question 2: When a surgeon requests a 'figure-of-eight' suture pattern, the primary purpose is:
- To close skin edges with minimal tension
- To provide additional strength and distribute tension at high-stress closure sites (Correct answer)
- To create a subcuticular buried closure for cosmesis
- To close tubular structures such as blood vessels
Correct answer: To provide additional strength and distribute tension at high-stress closure sites
A figure-of-eight suture distributes tension across a wider tissue area, providing reinforced closure at high-stress sites such as fascia or tendon repair.
Question 3: A Foley catheter is inserted preoperatively in surgical patients primarily to:
- Administer intravesical medications during the procedure
- Monitor urinary output and decompress the bladder to prevent injury (Correct answer)
- Prevent urinary tract infection during surgery
- Obtain a sterile urine specimen for culture
Correct answer: Monitor urinary output and decompress the bladder to prevent injury
Foley catheter insertion allows continuous urine output monitoring as a perfusion indicator and keeps the bladder decompressed to prevent accidental cystotomy.
Question 4: Which instrument is used to hold a needle securely for suturing deep in a cavity?
- Heaney needle holder (Correct answer)
- Crile-Wood needle holder
- Ryder needle holder
- Castro-Viejo needle holder
Correct answer: Heaney needle holder
The Heaney needle holder has a curved jaw designed specifically for suturing in deep pelvic and vaginal cavities where straight instruments cannot reach effectively.
Question 5: During a vascular anastomosis, the surgeon requests heparinized saline irrigation. The purpose is to:
- Flush bacteria from the arterial lumen
- Prevent thrombus formation in the vessel lumen during anastomosis (Correct answer)
- Dilate the vessel to ease suturing
- Test the anastomosis for leaks under pressure
Correct answer: Prevent thrombus formation in the vessel lumen during anastomosis
Heparinized saline flushes the vessel lumen to prevent clot formation in the stagnant blood column while the anastomosis is being constructed.
Question 6: What is the correct action if the sterile field becomes contaminated during surgery?
- Continue the procedure and document the contamination postoperatively
- Immediately inform the surgeon and correct the break in technique (Correct answer)
- Cover the contaminated area with a sterile drape and proceed
- Ask the circulator to re-sterilize the field using UV light
Correct answer: Immediately inform the surgeon and correct the break in technique
Any break in sterile technique must be immediately identified, announced, and corrected to prevent surgical site infection — delaying or concealing contamination is never acceptable.
Question 7: During ophthalmic surgery, the scrub tech must handle instruments with particular care because:
- The patient is typically awake under local anesthesia and any noise may cause movement
- Ophthalmic instruments have extremely fine, delicate tips that are easily damaged and costly to repair (Correct answer)
- The operative field is near the airway, increasing contamination risk
- Ophthalmic procedures use unsterile viscoelastic agents that could damage instruments
Correct answer: Ophthalmic instruments have extremely fine, delicate tips that are easily damaged and costly to repair
Ophthalmic instruments have microsurgical-caliber tips measured in fractions of a millimeter; even minor contact with hard surfaces can bend or damage them, rendering them non-functional.
Certified Surgical Technologist Intraoperative Procedures 5
During a laparotomy, the scrub tech is asked to load a TA stapler.
The TA stapler is used to: