A successful surgery requires the expertise of several people. We go behind the scenes at The Royal Marsden to discover who is needed in the operating theatre.
This patient had two large, potentially cancerous ovarian masses, so this surgery was investigative. The ovaries were sent for emergency analysis in the histopathology department for diagnosis and to determine the right course of treatment. The patient remained in hospital for just five days – a great outcome after such a major procedure.
Mr Thomas Ind
I’m the lead surgeon and have the ultimate responsibility for the patient. In this instance I carried out the majority of the operation with my co-surgeons, Stacey Bryan and Stavros Natsis. Generally speaking, the senior surgeon opens the tummy up, but it’s not always the case. When you do an operation, you’re in many different parts of the abdomen. Decision-making is about 75% of the surgery; I ask for everyone’s opinion, but the final decision always comes from me.
Dr Stavros Natsis
The surgical fellows assist the surgeon during the operation and sometimes perform part of the procedure. We get to see almost the full journey of the patient – we meet them in clinic, speak to them before the surgery to explain what the procedure involves and provide support with post-operative care.
Sister for Theatre and Scrub Nurse
An operating room nurse fulfils one of two roles: a scrub nurse or circulating nurse. On this occasion I was a circulating nurse, but my role alternated throughout the day as we had three different cases. We’re responsible for the patient’s care and safety, documenting everything that happens during the procedure. A circulating nurse is not sterile during the operation but provides the necessary help, materials and any equipment that cannot be accessed by the sterile surgical team.
Clockwise from left: Mr Thomas Ind, Dr Stavros Natsis and Jean Arjoon
My role involves making sure we have everything on the operating theatre list and that all the equipment is working. I focus on whatever the patient needs, and will help the surgical team position the patient on the operating table. I also assist the scrub nurse and act as the link between the surgical team and other parts of the theatre and hospital – I have an overview of the whole picture.
Dr Matthew Hacking
Lead Consultant Anaesthetist
As well as providing the anaesthetics to patients for surgery, I’m responsible for caring for them before, during and immediately after their operation. It’s my job to understand and pre-empt the likely course of an operation. I make sure they’re comfortable, safe and have as few side effects of surgery as possible, while treating any co-morbidities they may have. I also assess their fitness before the proposed operation and make sure they fully understand what they are about to experience.
Dr Stacey Bryan
I am part of the surgical team, so I assist the consultant surgeon, which sometimes involves performing part of the procedure and holding the retractors. I help to plan the surgeries beforehand and often see the patient in clinic, on the pre-operative ward, in surgery and then post-operatively as well, so I’m there for most of the patient’s journey in hospital.
Clockwise from left: Winnie Monzon, Dr Matthew Hacking and Dr Stacey Bryan
Sterile Scrub Nurse
The role of a sterile scrub nurse is to assist and support the surgeon during the procedure by ensuring they have everything they need at the right time, such as equipment and sutures. We’re responsible for patient care, so we’re accountable for everything on the trolley – preparing sterile materials and equipment and counting items such as sponges, needles and swabs. We have to make sure everything is accounted for at the end of the surgery and that nothing is left behind.
Operating Department Practitioner
I assist the lead consultant by setting up and preparing the anaesthetic room/theatre before the patient comes down. I make sure that everything is working and that we have available all the equipment, drugs and fluids that might possibly be required. I’ll check the patient as part of the World Health Organization’s Surgical Safety Checklist, and I’m present throughout the operation with the anaesthetist, supporting the patient’s needs.
Dr Josep Sanchis
Visiting surgeon from Spain
I’m a consultant and have finished my five-year residency programme in Spain to become a surgeon. The Royal Marsden is a pioneer and renowned for its willingness to share and to educate other medical professionals across the world in order to benefit cancer patients. I observed this surgery to learn about how this gynaecological procedure is performed. I’m in the UK for six weeks to learn as much as I can, and will apply this knowledge back at my hospital in Spain.
Clockwise from left: Catherine Has, Rachel Nabawanuka and Dr Josep Sanchis