Surgical Procedures I

Course Description

Surgical Procedures I prepares students for surgical work by covering diagnostic procedures and relevant equipment, supplies, and techniques. It addresses surgical anatomy and physiology across multiple specialties including general surgery, endoscopic procedures, gynecological and obstetrical surgery, genitourinary surgery, orthopedic surgery, and ophthalmic surgery, with attention to pathophysiology and relevant techniques.

Within the SCNS taxonomy, STS is the Surgical Technology prefix and the C suffix marks a combined lecture-and-laboratory course. Daytona State publishes the closely related STS1323 at 3 credits, offered spring, with STS1303 as prerequisite and STS1308 as corequisite.

⚠ STS1323C and STS1323 are distinct SCNS numbers. Under Rule 22 the C suffix is part of the course number and equivalency does not cross it. The Daytona entry is reliable evidence about what the course covers, and the suffix indicates a formally integrated lecture-and-laboratory structure. Published here at 3 credits and approximately 60 contact hours, matching Daytona State's STS1307C — the institution's only other three-credit C-suffixed surgical technology course. Confirm equivalency and hours with the receiving institution.

This is the first half of the procedures sequence, continued in STS2324C (Surgical Procedures II). Note the pairing the description makes between procedures and the anatomy of the region: surgical anatomy is learned by approach, not by system, and adopting that discipline early is what makes the knowledge usable in a case.

Learning Outcomes

Required Outcomes

• Describe diagnostic procedures relevant to surgical practice.
• Describe the equipment, supplies, and techniques used in diagnostic procedures.
• Describe surgical anatomy and physiology by region and approach.
• Describe pathophysiology underlying the conditions treated surgically.
• Describe general surgery procedures and their steps.
• Describe endoscopic and minimally invasive procedures and instrumentation.
• Describe gynaecological and obstetrical procedures.
• Describe genitourinary procedures.
• Describe orthopaedic procedures and their implants and equipment.
• Describe ophthalmic procedures and their specialised requirements.
• Describe indications and contraindications for the procedures studied.
• Describe patient positioning for each procedure and the injuries it prevents.
• Describe skin preparation and draping for each approach.
• Identify and select instrumentation for the procedures studied.
• Assemble appropriate instrument sets.
• Set up, test, and troubleshoot endoscopic equipment.
• Describe suture selection and prepare and pass suture correctly.
• Anticipate the surgeon's needs through the studied procedures.
• Describe haemostasis methods and the technologist's role.
• Describe medications and solutions used in the specialties studied.
• Describe specimen handling and documentation requirements.
• Apply counting procedures appropriate to each specialty.
• Maintain sterile technique through simulated procedures.
• Prepare complete case plans for the procedures studied.

Optional Outcomes

• Describe robotic approaches within the specialties studied.
• Describe paediatric variations on the procedures studied.
• Describe trauma and emergency presentations.
• Describe intraoperative imaging and its safety requirements.
• Describe emerging techniques in the specialties studied.
• Begin structured CST examination preparation.

Major Topics

Required Topics

• Diagnostic procedures
• Diagnostic equipment and supplies
• Surgical anatomy by region and approach
• Pathophysiology
• General surgery
• Endoscopic and minimally invasive procedures
• Gynaecological and obstetrical surgery
• Genitourinary surgery
• Orthopaedic surgery
• Ophthalmic surgery
• Indications and contraindications
• Positioning and injury prevention
• Preparation and draping
• Specialty instrumentation
• Instrument set assembly
• Endoscopic setup and troubleshooting
• Suture selection and handling
• Anticipating the surgeon
• Haemostasis
• Medications and solutions
• Specimen handling
• Counts by specialty
• Sterile technique in simulation
• Case planning

Optional Topics

• Robotic approaches
• Paediatric variations
• Trauma and emergency presentations
• Intraoperative imaging and safety
• Emerging techniques
• 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

⚠⚠ Daytona State runs two parallel surgical technology programmes — know which you are in

• There is a college-credit sequence (STS1302 upward) and a PSAV clock-hour certificate (STS0003 upward), and they carry near-identical course titles. STS0003 and STS1302 are both called "Introduction to Surgical Technology"; STS0120–0122 "Surgical Specialities" parallel STS1323/STS2324 "Surgical Procedures".
• They are different courses at different levels with different outcomes. The 1000- and 2000-level courses carry college credit that applies to a degree; the 0000-level courses carry clock hours and no college credit.
• Both routes can lead to the same job and to CST eligibility from an accredited programme — the difference is cost, duration, and whether you finish holding credit that counts toward a degree.
• Do not assume one substitutes for the other. They do not cross-count, and a course taken in one sequence generally does not satisfy the other.
• Confirm at enrolment which programme you are admitted to, and confirm its accreditation, because that is what governs your examination eligibility.
• If a degree is a longer-term goal, the credit route matters — see the note on PSAV articulation in this repository's STS0003 guide.

⚠ How to learn a procedures course

• Build case cards rather than memorising lists. Position, prep, drape, incision, layers in order, key steps, closure, and what the surgeon needs at each — that structure is what makes the knowledge retrievable in a room.
• Learn anatomy by what lies under the incision, in order. The textbook's system-by-system organisation is not the question the operating room asks.
• Anticipation is the skill. A good scrub has the instrument in the hand before it is requested, and that comes from knowing the sequence rather than from fast reflexes.
• Learn instruments by touch as well as by sight — you will identify them under a drape without looking.
• Endoscopic setup is examinable and practical. Learn the fault-finding sequence methodically; a tower that will not produce an image stops a case.
• Review the procedure the night before you see it. The same day teaches ten times as much when you can follow rather than merely watch.
• Your case cards become CST revision material and your reference in the first weeks of employment — write them properly the first time.

⚠⚠ 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.

STS1323C is a combined lecture-and-laboratory course, published here at 3 credits and approximately 60 contact hours. Daytona State publishes the related unsuffixed STS1323 at 3 credits, offered spring, with STS1303 as prerequisite and STS1308 as corequisite.

⚠ Under SCNS Rule 22 the C suffix is part of the course number, so STS1323C and STS1323 are distinct courses — confirm equivalency with the receiving institution. It continues in STS2324C (Surgical Procedures II); see that guide.