Responsibilities of a Scrub Nurse in a TAHBSO

A total abdominal hysterectomy with bilateral salpingo-oopherectomy (TAHBSO) is a gynecological operation that involves removing the uterus, ovaries and fallopian tubes through an abdominal incision. The scrub nurse assists the surgeons by having the proper instruments and supplies ready and aiding in retraction and suctioning when necessary. As with every procedure, her responsibilities begin before the patient enters the room and end after the patient leaves.

Preoperatively

• Before the patient is brought back to the room, the scrub nurse makes sure that the proper instruments and supplies are available for the procedure. She opens the appropriate sterile packs and trays before scrubbing in to organize and count them. After the patient is brought back to the room and anesthetized, she may perform the abdominal and vaginal prep with an iodine or chlorhexidine solution. She then gowns and gloves the surgeons and helps with draping.

Operatively

• Once the incision is made, the surgeons enter the abdominal cavity and visualize the uterus. The scrub nurse must have the appropriate self-retaining retractor and blades available. At various times during the procedure, he may be required to hold the self-retainer or additional retractors in certain positions. Removing the uterus, fallopian tubes and ovaries involves several steps that are repeated on both sides. The nurse must hand the surgeons the proper clamps, scissors and sutures quickly to allow for an efficient and safe procedure. Once the uterus is out, he will hand it to the circulating nurse to be sent for specimen, and count the instruments and supplies as the surgeons close the vaginal canal. He will count again when they begin closing the abdomen.

Postoperatively

• Once the procedure is finished, the scrub nurse helps the surgeons clean the patient of prep solution and blood. She then assists in dressing the incision. The instruments must be returned to their trays and brought to the decontamination room, while the operating room is cleaned and prepared for the next operation.