Martin Li, MA, CRCST, CER, CIS, CHL
Introduction Learning surgical instruments is a
critical step in becoming a Certified Instrument Specialist (CIS), especially
for professionals in sterile processing or those pursuing a career in surgery.
Mastering these instruments requires theoretical study,
practical experience, and continuous learning. Below, I outline the steps I
took to achieve my certification and expertise in surgical instruments,
supplemented with additional examples that deepened my understanding.
1. Study the Basics To begin with, I familiarized
myself with common surgical instruments' names, functions, and uses.
Resources like the HSPA Sterile Processing Technical Manual (9th Edition),
specifically Chapters 10 and 11, were incredibly valuable. Books like Differentiating
Surgical Instruments by Colleen J. Rutherford, with detailed descriptions
and images, provided a solid foundation.
For example, understanding the difference between a Kocher
forceps and an Allis tissue clamp helped me grasp the nuances of instrument
functionality.This foundation was crucial in identifying the core principles,
such as distinguishing between various types of forceps, retractors, and
clamps. Additionally, I often used anatomical diagrams to understand why
certain instruments were preferred for specific procedures, such as using
Debakey forceps for delicate tissue manipulation.
2. Watch Educational Videos Visual aids significantly reinforced my knowledge. Videos such as "Basic
Surgical Instruments" on YouTube provided real-time demonstrations of how
these instruments are used in practice. Platforms like TeachMeSurgery and Geeky
Medics offered instructional videos that broke down more complex tools, like
self-retaining retractors and diathermy pens, showing exactly how they are
applied in the operating room.
For example, videos explaining the step-by-step use of
laparoscopic instruments during a cholecystectomy helped me understand the
practical aspects of minimally invasive surgery, including how surgeons
navigate small spaces with precise tools.
3. Hands-On Practice Whenever possible, I engaged in
hands-on practice with surgical instruments. I started with basic tools like
scalpels, forceps, and scissors to understand their weight and balance.
Gradually, I moved on to more complex instruments, such as needle holders and
laparoscopic devices. Practicing with real instruments allowed me to develop
the precise hand movements needed for tasks like suturing, vessel ligation, and
tissue retraction.
For instance, learning to handle a Mayo-Hegar needle holder
helped me understand how to maintain stability while suturing, while practice
with laparoscopic forceps taught me about instrument angling and maneuvering
within the confined spaces of the abdominal cavity.
4. Attend Workshops or Courses Attending workshops at
local medical institutions provided hands-on guidance from experts, who
demonstrated proper instrument handling techniques. These sessions were
essential for mastering skills such as using retractors to safely expose
surgical sites. Workshops also introduced me to specialized instruments, such
as the Gigli saw for orthopedic surgeries and various suction devices for
neurosurgery.
One of the most impactful workshops I attended was focused
on laparoscopic instrumentation, where we practiced using a range of tools,
including trocars and clip applicators, in a simulated surgical setting. This
experience helped me understand the importance of instrument ergonomics and
precision during procedures.
5. Use Flashcards Flashcards became an indispensable
tool for memorization. I created my own by writing each instrument’s name, its
function, and a brief sketch. Platforms like Quizlet provided pre-made sets,
while Anki’s spaced repetition system helped me retain information over the
long term.
For example, I created flashcards to learn the subtle
differences between various types of scissors, such as Metzenbaum scissors for
cutting delicate tissue and Mayo scissors for heavier cutting tasks. This
method was especially useful for memorizing more obscure instruments, such as
Hohmann retractors and Kerrison rongeurs.
6. Join Study Groups Joining a study group allowed me
to collaborate with peers who were also pursuing CIS certification. We quizzed
each other on instruments, shared resources, and discussed how different
hospitals might use instruments slightly differently. This group interaction
helped reinforce my knowledge and introduced me to alternative study methods,
such as role-playing in mock surgical scenarios.
For instance, one of my peers introduced a technique where
we would simulate an operating room setup and assign roles to understand the
dynamics of surgical procedures. This exercise helped me appreciate the timing
and coordination required when passing instruments during surgery.
7. Break Down Instrument Categories Starting with
beginner-friendly textbooks like Differentiating Surgical Instruments, I
organized instruments into categories—manipulation, retraction, cutting,
suturing, and suction. Websites like TeachMeSurgery and Geeky Medics provided
categorized breakdowns, allowing me to cross-reference between resources.
I found this approach particularly useful when learning
about cutting instruments. Understanding the design and use of different
scissors, scalpels, and bone saws helped me quickly identify the right tool for
a specific task, whether it was cutting soft tissue or performing bone
dissection in orthopedic surgery.
8. Use Flashcards for Reinforcement Creating
personalized flashcards allowed me to tailor the learning process. Digital
platforms like Anki and Quizlet provided additional reinforcement through
spaced repetition. I used flashcards to memorize critical details, such as the
difference between atraumatic and traumatic forceps, or the correct grip for a
Mayo-Hegar needle holder.
For example, differentiating between a Kelly clamp and a
Crile clamp can be tricky due to their visual similarities. Flashcards helped
me remember key distinctions, such as their respective uses and designs,
ensuring I could identify them correctly in practice.
9. Mastering Various Instrument Categories Through
this journey, I developed proficiency in multiple categories of instruments:
- Manipulation:
Dissecting forceps (e.g., Debakey’s), tissue clamps
- Retraction:
Handheld and self-retaining retractors like the Gelpi or Balfour
retractors
- Cutting:
Curved and straight scissors, scalpels, and bone saws
- Suturing:
Needle holders, suture scissors
- Suction:
Yankauer and Frazier suction tips
By mastering these categories, I gained a comprehensive
understanding of how instruments are used in specific surgical contexts, from
abdominal surgeries to orthopedic procedures.
Conclusion By combining structured study, practical
experience, workshop participation, flashcards, and peer collaboration, I
successfully earned my CIS certification. These methods allowed me to build the
expertise required to manage surgical instruments effectively, ensure patient
safety, and support surgical teams in sterile processing. Continuous learning
and hands-on practice remain key to maintaining my skills, as the field of
surgical instrumentation continues to evolve.
July 16,
2024
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