Surgical Specialities II

Course Description

Surgical Specialities II is an introduction to additional surgical specialties and specific human anatomy of the area in which the surgical procedure is performed.

Within the SCNS taxonomy, STS is the Surgical Technology prefix, and the 0000-level number marks this as PSAV clock-hour instruction. Daytona State publishes it at 88.2 clock hours, offered spring, with STS0120 as prerequisite. ⚠ It carries no college credit.

At 88.2 hours this is the largest classroom course in the programme, and it sits in the same term as the 375-hour clinical rotation — the heaviest term of the certificate by a wide margin. It continues the specialties sequence into further areas of practice, and by this point the expectation shifts: you are no longer learning what a procedure is, but preparing to scrub it.

Learning Outcomes

Required Outcomes

• Describe the anatomy relevant to each additional specialty studied.
• Relate surgical approach to the anatomy encountered in sequence.
• Describe pathological conditions treated surgically in each specialty.
• Describe indications and contraindications for the procedures studied.
• Describe the steps of the procedures studied in each specialty.
• Describe patient positioning for each procedure and the injuries positioning prevents.
• Describe skin preparation and draping for each approach.
• Identify and select specialty instrumentation.
• Assemble complete instrument sets for the procedures studied.
• Describe and prepare specialty equipment, including powered and endoscopic equipment.
• Describe endoscopic and minimally invasive technique and its instrumentation.
• Set up, test, and troubleshoot endoscopic equipment.
• Describe implants and prostheses used in the specialties studied.
• Handle implants using correct technique and documentation.
• Select and prepare suture appropriate to tissue and procedure.
• Anticipate the surgeon's needs through complex procedures.
• Describe haemostatic techniques and agents used in each specialty.
• Describe specimen handling requirements specific to each specialty.
• Describe intraoperative complications and emergency conversions.
• Describe the response to intraoperative haemorrhage.
• Maintain sterile technique during complex and lengthy procedures.
• Apply counting procedures in complex cases.
• Describe radiation safety when imaging is used intraoperatively.
• Prepare complete case plans for the procedures studied.

Optional Outcomes

• Describe robotic surgery systems, setup, and instrumentation.
• Describe laser use and laser safety requirements.
• Describe transplant procedures and organ procurement.
• Describe trauma and emergency surgical management.
• Describe paediatric surgical variations.
• Continue structured CST examination preparation.

Major Topics

Required Topics

• Specialty anatomy
• Anatomy by approach
• Pathological conditions
• Indications and contraindications
• Procedure steps by specialty
• Positioning and injury prevention
• Preparation and draping
• Specialty instrumentation
• Instrument set assembly
• Powered and endoscopic equipment
• Minimally invasive technique
• Endoscopic setup and troubleshooting
• Implants and prostheses
• Implant handling and documentation
• Suture selection
• Anticipation in complex procedures
• Haemostatic techniques
• Specialty specimen handling
• Complications and conversions
• Intraoperative haemorrhage response
• Sterile technique in long cases
• Counts in complex cases
• Intraoperative radiation safety
• Case planning

Optional Topics

• Robotic surgery systems
• Laser use and safety
• Transplant and procurement
• Trauma and emergency surgery
• Paediatric variations
• CST examination preparation

Resources & Tools

• Surgical Technology for the Surgical Technologist: A Positive Care Approach (AST) — the core text, and the one the CST examination is built around.
• Alexander's Care of the Patient in Surgery — the comprehensive perioperative reference.
• Berry & Kohn's Operating Room Technique — the standard on technique and sterile practice.
• Surgical Instrumentation (Rutherford) — instrument identification, which is largely a memorisation task and needs a good picture reference.
• AST — Association of Surgical Technologists (ast.org) — the professional body; student membership is inexpensive and includes practice materials.
• NBSTSA (nbstsa.org) — free CST examination content outline and eligibility rules; read the eligibility page before you enrol anywhere.
• ARC/STSA (arcstsa.org) and CAAHEP (caahep.org) — free accreditation lookup; verify your programme.
• AORN (aorn.org) — perioperative nursing body whose Guidelines for Perioperative Practice are the standard the whole room works to.
• Flashcards for instruments, and a study partner — unglamorous and the single most effective study method in this programme.
• Anatomy atlas or app — surgical anatomy is approached by region and approach, not by system, and a visual reference helps.
• Your programme's mock operating room and open lab time — gowning, gloving, and draping are motor skills built only by repetition.

Career Pathways

• Surgical technologist — SOC 29-2055.
• Hospital operating rooms — the largest employer, and where most graduates begin.
• Ambulatory surgery centres — a large and growing Florida sector, frequently with better hours than hospital work.
• Specialty services — cardiovascular, neurosurgery, orthopaedics, and transplant; specialisation raises pay significantly.
• Labour and delivery — caesarean section teams.
• Physician offices and specialty clinics performing procedures.
• Central sterile processing — a related pathway with its own certification.
• Travel surgical technologist — substantially higher pay for mobility, once experienced.
• Surgical first assistant — an advanced role requiring further education and separate credentialing (CSFA); the usual route to higher earnings in this field.
• Medical device and instrument sales or clinical support — companies recruit experienced surgical technologists specifically for operating room credibility.
• Programme instruction — teaching in a surgical technology programme after several years in practice.
• ⚠ Progression to nursing, physician assistant, or other licensed roles requires separate degree programmes, and PSAV clock hours generally do not transfer into them — plan the pathway deliberately if that is the goal.

Special Information

⚠ Minimally invasive and powered equipment — setup failures stop cases

• Endoscopic equipment is the scrub's responsibility to set up and to troubleshoot, and a tower that will not produce an image stops a procedure with an anaesthetised patient on the table.
• Test everything before the patient is draped — camera, light source, insufflation, and monitor. Problems found early are inconvenient; found late they are serious.
• Learn the fault sequence. White balance, focus, connections, light cable, gas supply — work through it methodically rather than randomly.
• Handle the camera and light cable carefully. Fibre-optic cables are fragile and expensive, and a crushed or sharply bent cable degrades permanently.
• Light sources burn. An active light cable resting on a drape can ignite it — never leave one lying on the field.
• Know the insufflator alarms and what each indicates.
• Powered instruments require correct assembly and safety handling — keep them on safety when not in use, and never pass one activated.
• Anticipate conversion to open. The open set must be available and its location known before every minimally invasive case, because conversion is sometimes urgent.

⚠⚠ Implants demand documentation discipline

• Every implant is traceable to the patient, and recording it is a regulatory requirement, not paperwork — recalls depend on it.
• Record manufacturer, catalogue number, lot or serial number, and size, and keep the packaging until documented.
• Verify size and side aloud with the surgeon before opening. An opened implant is a charged implant, and a wrong-side or wrong-size opening is an expensive and reportable error.
• Do not open an implant until the surgeon confirms. Anticipation stops here; this is the one thing you wait to be told.
• Handle implants strictly aseptically and minimise contact — an infected implant frequently means removal and a second operation.
• Know the facility's flash or immediate-use sterilisation policy, which for implants is restrictive for good reason.

⚠⚠ This is a PSAV clock-hour course — it carries no college credit

• The leading zero in the course number is the signal. Under the Florida Statewide Course Numbering System, a 0000-level number denotes postsecondary adult vocational (PSAV) instruction, which is measured in clock hours rather than semester credit hours. These courses carry zero college credit.
• ⚠ A catalog may display the clock-hour figure under a heading that reads "credit hours." It is not credits. When you see a number like 192 or 375 attached to a 0000-level course, that is hours of instruction — no course is worth 375 semester credits.
• PSAV hours do not transfer as college credit to an associate or bachelor's degree, and they do not satisfy general education requirements.
• What they do produce is a workforce credential — a career certificate that qualifies you to sit a national certification examination and to be hired. For many students that is exactly the right outcome, and it is reached faster and more cheaply than a degree.
• Some institutions offer articulation from a PSAV certificate into a related associate degree, sometimes through an articulated credit agreement or a "gold standard" statewide articulation. ⚠ These are institution-specific and change. If your intention is to continue to a degree later, get the articulation in writing from the receiving institution before you enrol, not after you finish.
• Financial aid rules differ for clock-hour programmes. Eligibility, disbursement, and satisfactory-progress rules are not the same as for credit programmes — ask the financial aid office specifically about clock-hour programmes.
• Attendance is the currency. Clock-hour programmes track attendance directly, and hours missed generally must be made up; this is stricter than a typical credit course.

⚠⚠ Surgical conscience: if you break sterility and nobody saw, you say so

• This is the defining professional value of surgical technology, and it is taught from the first day because everything else rests on it.
• Sterility is absolute, not probabilistic. An item is sterile or it is not; there is no "probably fine." When in doubt, it is contaminated.
• You will contaminate something, and the only question is what you do next. Announcing your own break in technique — when no one else noticed and no one would ever know — is the whole of surgical conscience, and it is the single trait that defines a trustworthy surgical technologist.
• The consequence of staying silent is a surgical site infection in a real person. That is not an abstraction; it is prolonged illness, reoperation, and sometimes death.
• Know the boundaries of the sterile field — table height, gown front from chest to sterile-field level and sleeves from cuff up, and never turn your back on the field.
• Monitor everyone. Watching for other people's breaks in technique is part of the role, and saying so out loud is expected of you, not presumptuous.
• Movement discipline matters — sterile to sterile, non-sterile to non-sterile, face the field, and keep hands above waist and below shoulders.
• Verify every package. Integrity, indicators, expiry, and moisture — a wet package is a contaminated package.
• Speaking up is a clinical skill, and programmes assess it. A student who will not say "that's contaminated" to a surgeon is not yet safe to practise.

⚠⚠ Counts — a retained surgical item is a never event

• A sponge, needle, or instrument left inside a patient is classed as a "never event" — an error considered wholly preventable. The count is how it is prevented, and the scrub role owns it jointly with the circulator.
• Counts happen at defined points: before the procedure, before closure of a cavity, at the start of wound closure, and at skin closure, plus whenever staff change.
• Count audibly and together, with both people seeing each item as it is counted. A count performed silently or alone is not a count.
• Never remove counted items from the room during a procedure.
• A discrepancy stops the process. Recount, search the field and the floor, notify the surgeon, and an X-ray is taken if the item is not found. This is not negotiable and not a judgement call.
• Do not let pressure shorten the count. The end of a long case, an impatient team, and an urgent turnover are exactly the conditions under which retained items happen.
• Account for every needle and every blade fragment. Broken instrument tips count too.
• Document counts accurately — the record is the evidence that it was done.
• Emergencies do not remove the obligation; they change how it is managed, and the policy covers that.

⚠⚠ Sharps and bloodborne pathogens — your own safety

• The scrub role handles more sharps than anyone else in the room, and passing them is the highest-risk moment of a procedure.
• Use the hands-free or neutral zone technique. Sharps are placed in a designated basin or magnetic pad rather than passed hand to hand, and both people announce the transfer. This measurably reduces injuries and is the standard of practice.
• Never recap a needle by hand, and never reach into a basin blindly.
• Announce every sharp — "sharp back," "needle," "blade" — every time.
• One sharp on the field at a time where practical, and keep them contained rather than loose.
• Load and unload blades with an instrument, never with fingers.
• Standard precautions apply to every patient, because you do not know who is infectious and neither does the chart.
• Wear the protection: eye protection every case, plus double gloving, which is standard practice in many services and substantially reduces exposure.
• Report every exposure immediately. Post-exposure prophylaxis is time-critical, and students under-report injuries out of embarrassment — do not be one of them.
• Know the surgical smoke and radiation hazards too — evacuate plume, and wear lead when imaging is in use.

⚠⚠ Certification and accreditation — verify before you enrol

• The recognised credential is the CST — Certified Surgical Technologist, awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
• ⚠⚠ Eligibility to sit the CST examination generally requires graduation from a programme accredited by CAAHEP (through the ARC/STSA) or ABHES. Confirm a programme's accreditation before enrolling — this is the same trap as CAPTE for physical therapist assistants, and it is unrecoverable after the fact.
• Accredited programmes require a documented minimum number of surgical cases before graduation, commonly cited as 120, distributed across specialties and roles. Keep your case log meticulously and from the first day — reconstructing it later is difficult and sometimes impossible.
• Most employers require certification even where the law does not, and many require it within a set period after hire.
• Certification is maintained by continuing education or re-examination on a defined cycle.
• ⚠ State regulation of surgical technologists varies and has changed in several states. Florida has not historically licensed surgical technologists as a separate licensed profession in the way it licenses nurses or physical therapist assistants, but requirements set by statute, by facility, and by accreditor do change.
• ⚠ Rule 11 applies. Verify current certification, accreditation, and any state requirements directly with NBSTSA, the accreditor, and the Florida Department of Health rather than relying on any course guide, including this one.
• Background screening and drug testing are required for clinical placement, and a criminal record can end a career pathway before it starts — raise any concern with the programme early and privately.

⚠ The physical and psychological demands are real

• You stand still for hours. Long cases mean sustained standing in one position, frequently with arms elevated, and it is more fatiguing than moving work. Supportive footwear and compression stockings are a genuine professional investment.
• You lift. Instrument trays are heavy, and patient positioning and transfers are part of the job — use the equipment and the team.
• Operating rooms are cold, and you will be gowned and gloved for hours without the ability to adjust anything.
• Bathroom and meal breaks are constrained by the case, which surprises students more than anything else. Hydrate and eat before a long list, sensibly.
• Radiation exposure occurs when imaging is used intraoperatively — wear lead, use distance, and monitor with a dosimeter where provided.
• Latex and chemical sensitivities matter here; disclose them to the programme early.
• You will see trauma, and some cases end badly. Paediatric cases and unexpected deaths affect experienced staff, and it is normal to be affected. Know what support the programme and the facility provide, and use it.
• The culture can be blunt under pressure. Sharp instruction during a critical moment is about the case, not about you — but genuine abuse is not acceptable, and there is a route to report it.

STS0121 is 88.2 clock hours — use the exact catalog figure of 88.2 for programme hour-counting. Offered spring, with STS0120 as prerequisite. ⚠ Clock hours carry no college credit.

⚠ Spring is the programme's heaviest term — this course runs alongside STS0008 and the 375-hour STS0256L clinical rotation. Plan your outside commitments accordingly.