Surgical Procedures II

Course Description

STS2324C – Surgical Procedures II is the second procedures course in a surgical technology program, typically 4 credits, and it covers the surgical specialties by system. Where STS1302C established the operating room, sterile technique, and instrumentation generally, this course applies that foundation to specific operations: what the procedure accomplishes, what anatomy it involves, what instruments and supplies it requires, and what the scrub must have ready before the surgeon asks.

The organizing skill is anticipation. A competent surgical technologist knows the steps of a procedure well enough to have the next instrument in hand before it is requested, to recognize when the surgeon has deviated from the expected course, and to have the necessary supplies open before they become urgent. That requires memorizing procedures in sequence — which is what this course does.

Content varies by program but typically covers specialties including general surgery — abdominal, hernia, biliary, and bowel procedures; obstetric and gynecologic surgery; genitourinary surgery; orthopedic surgery — fracture fixation, arthroplasty, and arthroscopy, with its distinctive heavy instrumentation and implant systems; otorhinolaryngology and oral and maxillofacial surgery; ophthalmic surgery and its microsurgical requirements; plastic and reconstructive surgery; cardiothoracic surgery; peripheral vascular surgery; and neurosurgery. For each, the course addresses relevant anatomy and pathology, patient positioning and prep, draping, instrumentation and equipment, the procedural sequence, specimen handling, and potential complications.

Offered at approximately 12 Florida institutions with surgical technology programs.

Learning Outcomes

Required Outcomes

• Describe the anatomy and pathophysiology relevant to procedures in each specialty studied.
• Describe the purpose, indications, and expected outcome of common surgical procedures.
• State the procedural steps of common operations in sequence.
• Select and prepare instrumentation, supplies, and equipment for a specified procedure.
• Identify specialty instruments and describe their function.
• Describe patient positioning for each specialty and its physiological and safety considerations.
• Describe skin preparation and draping appropriate to each procedure.
• Anticipate the surgeon's needs and describe the rationale for each anticipated item.
• Describe suture, implant, and graft selection appropriate to each specialty.
• Describe the setup and safe use of specialty equipment including powered instruments and endoscopic systems.
• Describe medications and solutions used on the sterile field and their handling and labeling.
• Handle and label specimens correctly for each procedure type.
• Perform counts appropriate to the procedure and describe the incorrect-count response.
• Identify potential intraoperative complications and describe the technologist's response.
• Apply electrosurgical, laser, and fire safety practices appropriate to each specialty.
• Maintain sterile technique throughout a simulated procedure.
• Demonstrate assigned competencies to program standards.

Optional Outcomes

• Describe robotic surgical systems and the technologist's role with them.
• Describe transplant and organ procurement procedures.
• Describe pediatric surgical considerations.
• Describe trauma and emergency surgical response.
• Describe ambulatory surgery center workflow.
• Prepare for the CST certification examination.

Major Topics

Required Topics

• General surgery — laparotomy, appendectomy, cholecystectomy, hernia repair, and bowel resection.
• Minimally invasive surgery — laparoscopic setup, insufflation, camera, and instrumentation.
• Obstetric and gynecologic surgery — cesarean section, hysterectomy, and laparoscopic procedures.
• Genitourinary surgery — cystoscopy, TURP, and nephrectomy.
• Orthopedic surgery — fracture fixation, arthroplasty, arthroscopy, and implant systems.
• Otorhinolaryngology — tonsillectomy, sinus surgery, and tympanoplasty.
• Oral and maxillofacial surgery — facial fracture repair and dental procedures.
• Ophthalmic surgery — cataract extraction and microsurgical technique.
• Plastic and reconstructive surgery — grafts, flaps, and cosmetic procedures.
• Cardiothoracic surgery — thoracotomy, CABG, and valve procedures.
• Peripheral vascular surgery — endarterectomy, bypass, and access procedures.
• Neurosurgery — craniotomy and spinal procedures.
• Positioning by specialty — supine, prone, lateral, lithotomy, and beach chair.
• Specialty instrumentation — identification, assembly, and handling.
• Equipment — powered instruments, endoscopic towers, microscopes, and lasers.
• Medications on the field — handling, labeling, and verification.
• Complications — hemorrhage, and the technologist's role in emergencies.
• Laboratory and simulation — mock procedure setup and competency checkoff.

Optional Topics

• Robotic surgery platforms.
• Transplant and procurement.
• Pediatric surgery.
• Trauma surgery.
• Ambulatory surgery center practice.
• CST examination preparation.

Resources & Tools

• Surgical Technology for the Surgical Technologist: A Positive Care Approach (AST), Cengage — the association text and standard adoption.
• Alexander's Care of the Patient in Surgery (Rothrock), Elsevier — the comprehensive procedural reference.
• Surgical Instrumentation (Phillips or Rutherford) — specialty instrument identification.
• AORN Guidelines for Perioperative Practice — the standard most operating rooms follow.
• NBSTSA — the CST examination content outline; this course covers a large share of it.
• Association of Surgical Technologists (AST) — standards of practice and student membership.
• Mock operating room — table, back table, Mayo stands, specialty instrument sets, and equipment.
• Procedure cards or preference cards — the working documents that specify setup for each surgeon and procedure; students should learn to read and build them.

Career Pathways

• Surgical Technologist (SOC 29-2055) — hospitals, ambulatory surgery centers, and specialty practices.
• Specialty scrub — cardiovascular, neurosurgery, orthopedics, ophthalmology, or transplant; typically higher paid.
• Surgical First Assistant — requires additional education and CSFA certification.
• Robotics-trained technologist — an expanding specialization.
• Sterile Processing lead or manager.
• Surgical device sales and clinical specialist — manufacturers recruit experienced technologists, particularly in orthopedics.
• Surgical technology instructor — with experience and credentials.

Florida's hospital systems and its very large volume of ambulatory surgery centers — driven partly by the state's older population and elective orthopedic and ophthalmic caseload — sustain steady demand, and orthopedic and ophthalmic specialization is particularly employable in Florida for the same reason.

Special Information

Anticipation is the skill, and it is built by memorizing sequences

Surgeons do not narrate their needs. The technologist who has the right instrument in hand at the right moment is the one who has memorized the procedure well enough to know what comes next — and who is watching the field rather than the back table. That is why this course requires learning procedures step by step rather than in general terms. Students who study procedures as narratives, rehearsing them aloud in order, retain them far better than those who study instrument lists alone.

Preference cards are the real working document

Every surgeon has a preference card specifying instruments, supplies, sutures, and setup for each procedure they perform, and it varies from surgeon to surgeon for the same operation. Learning to read one, pull from it accurately, and note discrepancies for correction is a directly employable skill that students often underestimate. A new technologist who follows the card precisely and flags what is missing is immediately useful.

Orthopedics is instrumentation-heavy and its own world

Orthopedic cases involve large, complex implant systems with vendor-supplied trays, specific insertion sequences, and manufacturer representatives in the room. The instrument volume is far greater than in general surgery, sets are heavy, and the specificity is unforgiving — the wrong screw length or the wrong broach means delay. Given Florida's joint replacement volume, orthopedic competence is worth building deliberately.

Fire and electrosurgical safety are procedure-specific

The operating room fire triangle — oxidizer, ignition source, and fuel — is present in every case, and the risk concentrates in head, neck, and airway surgery where supplemental oxygen, alcohol-based prep, and electrosurgery combine. Students should learn the specific precautions for those cases rather than treating fire safety as a general topic.

Certification and accreditation

The Certified Surgical Technologist (CST) credential from NBSTSA is what Florida employers require, and eligibility generally depends on graduating from a CAAHEP- or ABHES-accredited program. This course covers a large share of the examination's procedural content, so it is worth studying with the examination in mind rather than only for the course grade. Florida does not license surgical technologists, which makes the national certification the operative credential.

Numbering and sequence

The procedures sequence typically runs STS2323 (Surgical Procedures I) then STS2324 (Surgical Procedures II), each often with a corresponding L laboratory or carried as a combined C course, alongside clinical practicum courses that carry far more contact hours than credits. Institutions distribute specialties across the sequence differently — verify locally which specialties this course covers at your institution. SCNS equivalency applies to the same number at the same level, never across numbers.