Principles of First Assisting in Cardiovascular Surgery

The quality of surgical assistance is an important factor affecting surgical performance and outcomes. This article gives a perspective on key principles of first assisting, specifically during cardiovascular operations. The principles start with operative techniques, then expand into concepts relating to the surgical field and operating room. By adhering to the described principles, the first assistant may enhance a surgical operation, benefiting the surgeon, the operating room team, and, most important, the patient.

Excellent first assisting adds efficiency, elegance, and assistance has been identified as a key intraoperative stressor for the primary surgeon, potentially affecting his or her surgical performance and contributing to complications. During an operation, a part of the primary surgeon’s mind tracks the first assistant: What action is he or she performing? How well is the action being done? Is the action advancing or impeding the operation? The primary responsibility of a first assistant, in our view, is“do no harm.” The second responsibility is to facilitate the flow of the operation by helping the primary surgeon. The“perfect surgical assistant has been described as“calm, confident, competent, and courageous.” In addition to these attributes, the following principles should be considered specifically when assisting in cardiovascular operations