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How surgical techs lay out the sterile field in the order it's needed, and 370+ real setups that show what goes on the table for each procedure, in the free app too.
Pancreaticoduodenectomy (Whipple)70 instruments on the back tableThere's no one right way: the surgeon, the facility and the tech all shape a setup, and many ORs standardize theirs so anyone covering a break can find everything. This is the routine most programs teach.
The big sterile work surface, and the first thing you set up. Everything opened for the case lives here in zones: the instruments, sutures, sponges, drapes, the spares and anything you won't need right away.
A small table with one open end that rolls in over the patient, in front of you. Its height adjusts to the field. It holds only what starts the case and what gets passed again and again.
Divide the table into three zones and give everything one home. Standing on the other side? Mirror it.
Beside you and the Mayo: what you'll reach for during the case.
The instrument pan, or its instruments laid out on a rolled towel.
Stacked in the order they'll be used, first on top.
Put it where it lives and leave it. Shuffling items around costs time and risks contamination.
Sutures, sponges, sharps, clips and syringes each in one place. It makes the count faster.
Finish it, then move on. Stay centred and keep your movement over the field small.
Once the basin set is unpacked, the ESU pencil, light handles and suction tubing can wait in one.
It doubles your sterile space. Keep your hands inside the cover's cuff as you ease it over the open end.
One or two towels cushion the instruments and stop a needle going through the cover.
Sponges, knife handles with the blades on, scissors, forceps, a few clamps, shallow retractors and ties. The ESU pencil and holster go up as soon as the patient is draped.
Cutting, clamping, grasping and retracting, and the Mayo covers what the surgeon asks for first.
The same number in the same place every case keeps you quick and the count easy.
They won't spring open as you pass them, and they open easily in the surgeon's hand.
As the surgeon works deeper, swap short instruments for long ones from the back table.
70 instruments. Picking the Mayo means taking from each row.
Curved Hemostats
Mosquito Clamp - Curved
Kelly Forceps
#3 Knife Handle
Straight Mayo Scissor
Curved Mayo Scissor
DeBakey Forceps
Ferris Smith Tissue Forceps
Russian Tissue Forceps
Yankauer Suction
Poole Suction Probe
Ferg-Frazier Suction
Stapler Reload
Ligating Clips
Umbilical TapeReady what the case starts with first. If the patient rolls in early, you can still begin.
It lists the surgeon's instruments, supplies, sutures, glove size and draping routine. Pull the extras before you open anything.
The back table pack goes first, centred, and opens into the sterile surface everything else lands on. Check each package for its indicator, tears and water marks.
Open them on a small separate table, never on the back table. Then scrub, gown and glove.
Cover it, then lay a towel or two on top.
Towels and gowns in order of use, and the drapes with the first one on top.
Into an empty basin, ready to go up as soon as the patient is draped.
Mount the blades and set out the starting instruments.
Grouped by type on the back table, sharps on the magnetic counter, ready to count.
Lift the inner tray straight up out of its container and check the indicator inside before you use anything. Lay the instruments out by job.
In the same order every time, each item seen and said out loud by you both.
The rest is secondary setup. Give yourself at least 20 minutes for a major case, and never leave an open room unattended.
370+ procedures, each with the instruments on its back table, the positioning, the drapes and the case step by step. General is free.
Its instruments become flashcards, a practice test and a timed exam, so you know the Pancreaticoduodenectomy (Whipple) table before you scrub it.
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Pro is also in the CSTSetup app, on the same account. Already have Pro? Log in
The CSTSetup app has every back table in setup mode and flashcard mode, so you can run through tomorrow's case on the way in. It's free to download, and every General setup is free inside it. One account and one Pro, on the site and in the app.
The instruments that start the case and get passed the most: knife handles with blades, scissors, tissue forceps, clamps, shallow retractors, sponges and ties. Keep it to a few from each job, and restock it from the back table as the case goes deeper.
Everything else opened for the case, in zones: a working area beside you for sutures, sharps, sponges and extra instruments; the instruments laid out by job; and gowns, gloves and drapes stacked in order of use. Basins and medicine cups sit at the edge.
Slide the cover over the open end with your gloved hands well inside its folded cuff, so they never touch the stand. The circulator can pull the bottom edge down for you. Then lay one or two towels on top.
No. Surgeon preference, the facility and the tech all change it, and many ORs standardize so whoever covers a break can find everything. What matters is a routine you repeat on every case.
Allow at least 20 minutes for a major case, and more for a complex one. Open as close to the start as you can, and keep an open room watched the whole time.
The surgeon's list for a case: instruments, supplies, sutures, glove size, the draping routine and notes. The setups here are the shared version, and you can make your own for each surgeon.
Pro opens every setup in every specialty, with its flashcards, practice test and timed exam.
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