In this episode of the Surgical Assistant Podcast, Kelly and John welcome surgical educator, author, and former ASA vice president Rebecca Hall to discuss strengthening surgical assisting through education, resources, and professional standards. Rebecca explains how her pocket guide, Suture and Surgical Hemostasis (2nd edition), grew from teaching tools she created for students, and why updates like mesh, new sutures, and evolving technology matter for assistants making real-time closure decisions. They also cover The Practice and Principles of Surgical Assisting (2025), inspired by Karen Ludwig’s vision for an ASA-based textbook written by surgical assistants to better reflect OR realities. The conversation highlights ethics, scope of practice, independent practice, gaps in hands-on training and access to H&Ps/EHRs, and the need for more relevant CE content created by working assistants.

https://www.amazon.com/Suture-Surgical-Hemostasis-Pocket-Guide/dp/1416022473https://www.amazon.com/Practice-Principles-Surgical-Assisting/dp/126426437200:00 Welcome and Guest Introduction

.01:52 Rebecca's Background and Credentials

02:57 Location Update to Ohio

04:23 Creating the Suture Pocket Guide

05:43 Importance of Suture Knowledge

07:51 Second Edition Updates09:04 The Surgical Assisting Textbook

09:27 Karen Ludwig's Legacy

10:46 Need for More Resources

11:52 Ethics and Scope of Practice

14:21 Standing Up for Your Limits

15:46 Creating Resources for the Field

17:44 Available Textbooks and Materials

19:21 Improving Surgical Assistant Education

20:41 Improving CE Courses

21:42 Writing CE Articles

23:23 Sharing Knowledge and Experience

24:14 Defining Excellence in Surgical Assisting

26:26 Learning Surgeonese

27:55 Patient History and H&Ps

30:20 Epic Access for Assistants

32:27 Discussing Surgical Technique

33:55 Education Program Challenges

37:15 Hands-On Training Standards

38:54 Hospital Utilization Issues

40:59 Closing Thoughts and Resources

Kelly and John continue their hernia series with a practical discussion of hiatal and paraesophageal hernias for surgical first assistants, clarifying the four types (type I sliding vs types II–IV paraesophageal/giant) and why case details matter for preparation. They review key anatomy and risks near the hiatus (including aorta, pleura, vagus nerves, short gastrics) and emphasize reading the H&P, communicating with the surgeon, and anticipating equipment needs. John walks through major laparoscopic steps and common variations, including hernia sac reduction, mediastinal dissection, crural closure (EndoStitch vs swedged-on needle), bougie sizing, mesh options, Penrose for esophageal retraction, and Nissen vs Toupet fundoplication, plus complications like dysphagia, gas bloat, and pneumothorax. Kelly adds robotic setup considerations such as docking, port placement, AirSeal, instrument choices, and liver retraction options.

Robotic ApproachVideo by Dr. David Lourie:https://youtu.be/UfRGXkUY0ew?si=xAMjVgFa8Uzt95wg

Robotic approach (SAGES) by Caitlin Houghton

https://youtu.be/GbdQVAmRXro?si=XBzFY-kQCkHERqQV

Laparoscopic Approach:

https://youtu.be/7XmBH39KzcA?si=3JEHL42Vz7YDcQdx

https://youtu.be/4_ED29Dt-Bg?si=2yzxZSelMW8gQh6H

https://youtu.be/4_ED29Dt-Bg?si=USIUC5JT-4vn3g-x

In this episode of the Surgical Assistant Podcast, John and Kelly break down ventral, umbilical, and incisional hernias from the surgical first assistant’s point of view, focusing on anatomy, how defects form, and why risk factors like obesity, pregnancy, smoking, diabetes, prior surgery, increased intra-abdominal pressure, and especially wound infection matter for recurrence and outcomes. They review common presentations (pain, bulge), the role of clinical exam and CT imaging, and clarify reducible vs incarcerated vs strangulated hernias and why urgent cases are about freeing compromised bowel. The discussion includes operative considerations such as exposure, protecting bowel, lysis of adhesions, defect measurement, mesh sizing and handling, suture choices, open primary vs open mesh repairs, and robotic positioning tips, plus a practical “vacuum pack/space bag” umbilical dressing technique to help reduce seroma formation.