The Go-To Guide for Assisting in a Laparoscopic Hysterectomy

INTRODUCTION: Laparoscopic hysterectomy (LH) is among the most commonly performed surgeries in the United States, relying on a skilled, two-person surgical team. Effective assistance in laparoscopic surgery is critical for maintaining efficiency, safety, and precision. Junior surgical assistants, whether residents, medical students, surgical PAs, or NPs, often lack adequate training in the nuanced skills required for assisting LH. A well-prepared assistant not only improves surgical flow but may also contribute to better patient outcomes. While technical videos typically focus on the surgeon’s role, there is a significant gap in instructional materials that emphasize the critical role of the assistant. OBJECTIVE: The primary goal of this video is to equip gynecologic surgery assistants with valuable insights necessary for effectively assisting in LH. By introducing novel visual aids, real-life analogies, and distinct terminology, the video aims to prevent miscommunication and frustration in the operating room (OR), while fostering surgical harmony and enhancing the learning experience for the trainees. Understanding the role and intricacies of being an excellent assistant will also provide a full understanding of the critical views during LH, facilitating the transition from assistant to primary surgeon. METHODS: This educational video offers a step-by-step guide for surgical assistants during LH, utilizing real-life analogies, unique descriptions, and visual aids to create a shared understanding of key moves between the assistant and surgeon. Parallels between surgical moves and everyday activities, such as driving a car or cutting fabric, are used to facilitate intuitive learning and retention. The video covers important laparoscopic principles such as optimal visualization, traction-countertraction, and presenting vessels at 90 degrees for optimal sealing. Specific techniques highlighted include the uterine “T-pose,” the “overhead side stretch pose,” and “rope pulling,” all of which are essential for assisting in LH and visualization of critical views. RESULTS: The video provides a comprehensive surgical guide from the assistant’s perspective, emphasizing the practical application of fundamental surgical principles and key moves to promote surgical efficiency. CONCLUSIONS: This video introduces a novel approach to training laparoscopic assistants by employing visual aids and real-life analogies to simplify complex tasks by creating distinct terminology to be used in the OR in real time. By mastering these key moves, assistants can provide high-quality, efficient support during LH, creating a foundation for their future role as lead surgeons. The methods presented in this video equip assistants with essential knowledge and techniques that go beyond LH, providing lasting benefits in surgical training and practice. Additionally, this enhanced understanding of laparoscopic principles may enable the learners to guide their future assistants more effectively.