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Operating Room Skills Check List Name:_____________________________________________________________ DATE:_______________________________________________________________ Please mark your level of experience 1. No theory and/or experience 2. Limited experience/need supervision and/or support 3. Experienced/minimal support needed to perform 4. Proficient/can perform independently General Surgery Abdominal Perineal Resection Appendectomy/Cholescystectony Breat Biopsy Colon Resection Gastric Bypass/Roux-en-Y Hemorrhoidectomy Hemiorrhapy-Inguinal, Ventral, Femoral, Umbilical Laparoscopic General Surgeries Laparoscopic Nissen Fundoplication Mastectomy Splenectomy Thyroidectomy Scrub General Surgery Cardiovascular Aorta Repair Aorto-Bifemoral/Femoral-Pop Bypass Graft Cardiac Bypass Surgery Carotid Endarterectomy Endoscopic Vascular Procedures Femoral Popliteal Bypass Graft Laparascopic Cardiac Surgery Robotic Assisted Cardiac Surgery Valve Replacement/Repair 1 2 3 4 Ventricular Assist Device Scrub CV Surgerytroke Scale Thoracic Endoscopic Thoracic Procedures Esophagoogastrectomy Mediastinotomy/Sternotomy Thoracoscopy/Nuss Procedure Thoracotomy Scrub Thoracic Surgery Orthopedic Total Joint Replacement Closed Reduction of Fracture External Fixator Cannulated Hip Screws Bankhart Procedures Birmingham Procedure Carpal Tunnel Release Arthroscopy Anterior Cruciate Ligament Reconstructions Open Reduction Internal Fixation Scrub Orthopedics Neurological Craniotomy Steriotactic Guided Brain Biopsy Laminectomy Laparoscopic Anterior Laminectomy Insertion of Vagal Nerve Stimulator Insertion of VP Shunt Spinal Fusion Anterior Cervical Discectomy with Fusion Posterior Cervical Laminectomy Scrub Neurological Surgery Genitourinary Vasicaurethropexy Marshall Marchetti Circumcision Cystoscopy/Cystogram/Pyelogram Prostatectomy Nephrectomy Orchidectomy/Orchidopexy Ureterostomy Laparoscopic Assisted GU Procedures Robotic Assisted GU Procedures Scrub GU Surgery Gynecological Abdominal Hysterectomy Anterior Posterior Repair C-Section D&C Laparoscopic Assisted Hysterectomy Laparotomy with Microtuboplasty Robotic Assisted GYN Procedures Vaginal Delivery Vaginal Hysterectomy Scrub GYN Surgery Ear/Nose/Throat Endoscopic ENT Procedures Laryngectomy Mastoidectomy Myringotomy with Insertion of Tubes Radical Neck Septoplasty Tonsillectomy & Adenoidectomy Tracheostomy Tympanoplasty Scrub ENT Surgery Craniofacial/Oral Craniectomy Craniofacial Reconstruction Dental Surgery Lefort 1 Maxillary/Sagittal Osteotomy ORIF Mandibular Fracture Otolasty Reconstruction of Ear Removal of Arch Bars Repair of Cleft Lip, Nose, Palate Rhinoplasty Scrub Craniofacial/Oral Plastic Blephoroplasty Breast Reconstruction with Implant Breast Reduction Mammoplasty Face Lift Mastectomy with Tram Flap Reconstruction Split Thickness Skin Graft Suction Lipectomy Srub Plastice Transplants Heart Lung Liver Pancreas Eye Organ Donation Scrub Transplants EMR Epic Cerner Eclipsys McKesson Meditech Certifications BLS PALS Other
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