14 - Obstetric and gynaecological surgery

Summary

Obstetric operations

The Obstetric operation essentially refers to a Caesarean Section (CS). This operation is usually a joy to perform and is most often associated with a positive outcome. However it can be very stressful, as events can suddenly turn for the worse, with two or more lives at stake. Also, unlike most other operations, CS often must be performed urgently to minimise foetal distress. Consequently, most surgeons performing CS greatly appreciate an assistant who has some prior understanding of the operation. It is therefore strongly recommended that you familiarise yourself with the steps of the operation beforehand, either by reference to an operative text (see ‘suggested further reading’, p. 123) or by discussion with a senior colleague.

The hazard of fainting in the operating theatre is particularly real at CS. This is because the temperature of the operating theatre is deliberately raised, to reduce the risk of hypothermia to the infant (see ‘If you feel faint’ p. 8 for further advice).

Before scrubbing, it is recommended that you don a waterproof gown or apron (see p. 36), to protect yourself from blood and amniotic fluid.

During the operation, the woman lies on the operating table on her back. A righthanded surgeon will almost always stand on the woman's right side. You, the assistant, will stand opposite the surgeon (i.e. almost always on the woman's left side).

As for most operations, a standard skin preparation and draping with sterile towels is done.