John and Kelly welcome surgical first assistant and advocate Amy Burton to discuss pathways into first assisting, the legal and patient-safety risks of “dual rolling” as both first assistant and scrub tech, and why malpractice coverage, documentation, and courtroom scrutiny make it unsafe despite staffing pressures. Amy shares her career shift from banking to CST, early transition into first assisting, independent practice challenges, and later stability with a surgical services group across Texas and Florida, noting differences in certification, licensure, and professional respect. She describes how a retained lap case led to expert witness work and increased advocacy through ASA involvement, social media content, and her role as COO of Surgefluencers to raise awareness of assistants’ value beyond “camera holding.” The conversation covers misconceptions about the role, professionalism, networking, conferences, the need for legislation and certification, and building trust with surgeons through teamwork, humility, and patient-focused leadership.

https://www.surgfluencers.com/

https://www.instagram.com/assist_this/

https://www.linkedin.com/in/amy-burton-csfa-lsa/?lipi=urn%3Ali%3Apage%3Ad_flagship3_profile_view_base_contact_details%3BopZ%2BdlKURGOaNlzvlJ0ItA%3D%3D

https://www.linkedin.com/company/vytalentsolutions/?lipi=urn%3Ali%3Apage%3Ad_flagship3_detail_base%3Btkaor2YzSZWBFitjLR8%2F2g%3D%3D

https://allstarssurgical.com/

00:00 Welcome and Guest Intro

00:54 Dual Role Debate

02:13 Legal and Safety Risks

03:43 Understaffing and Boundaries

05:31 Amy’s Career Path

08:56 Advocacy and Social Media

09:57 Expert Witness and Surgefluencers

12:07 Public Awareness and Career Outreach

16:18 Challenges Facing Assistants

18:24 Misconceptions About the Role

24:22 Professionalism and Networking

26:02 Earning Surgeon Trust

31:29 Earning Surgeon Trust

32:43 Quiet Leadership in the OR

35:43 Advocating for Patients

36:55 Humility and Lifelong Learning

39:38 Owning Mistakes Protecting Team

41:06 Future of the Profession

42:44 Legislation and ASA Membership

46:32 Conferences and Continuing Education

52:04 Where to Find Amy

53:46 Final Wrap Up

John and Kelly welcome James Romero from New Wave Endo for a product spotlight and demonstration of the MClose Port Site Pain Management Closure System used in laparoscopic and robotic port closure. James explains how MClose deploys two needles simultaneously for consistent 1 cm, 180-degree suture placement, enables local anesthetic delivery to the nerve plane via a first “click,” and improves safety by avoiding exposed needles and reducing risk near bowel. They cover kit contents, wire loading, the three-click workflow, common troubleshooting (missing the second click, thin-patient skin capture, plunger retraction), and techniques for large defects (apex-to-apex, multiple sutures). The group discusses reduced dimpling, less pain and opioid requests, learning curve, use cases (8 mm and larger), and pricing around the $80 range, plus how to request demos, trials, and training via New Wave Endo.

Videos Mentioned by James:

step-by-step instruction video:https://vimeo.com/1088939567?share=copy&fl=cl&fe=ci

https://youtu.be/4W0h883TJWk?si=tfWM3KjOlI1eAooZ

https://pubmed.ncbi.nlm.nih.gov/17666655/

https://europepmc.org/article/MED/17666655

00:00 Welcome and Setup

00:44 Meet James Romero

02:01 Why MClose Exists

03:12 Kit Contents Overview

04:29 Reloading the Wire

05:32 Consistent Safe Needle Placement

06:19 Trocar Through-Trocar Technique

07:10 Three Click Workflow Demo

10:07 Suture Loading and Removal

13:23 Clinical Benefits and Outcomes

14:51 Thin Patient Tips

16:48 Training and Demo Kits

17:44 Cost and Value Comparison

22:10 Learning Curve and OR Adoption

23:13 Bleeding Case Evidence

23:57 Three Clicks Troubleshooting

25:34 Speed and Handling Tips

27:37 Closing Large Defects

29:58 Cost and Value Pitch

31:43 Safety and Pain Benefits

34:36 Port Size Guidelines

38:37 Wrap Up and Resources

On the Surgical Assistant Podcast, John and Kelly interviewChristopher Sweebe, CSFA and founder/CEO of Precision Surgical Resources, about helping surgical assistants transition from W2 employment to independent 1099practice without getting overwhelmed by business operations. Sweebe explains PSR’s “fractional back office” model and partnerships (including All Starz anda long-time billing company) that support LLC setup, insurance, taxes, credentialing, collections, and facility contracting, while emphasizing that market factors like payer mix and state rules can determine whether independence is viable. He highlights common reimbursement barriers and a key documentation “pearl” for avoiding denials: the op note must include the assistant’s name and credential and clearly state why they were needed and what they did. The episode also covers PSR’s 20% fee, Weekly Fridaypayments,transparency, lack of non-competes, and longer-term efforts like grants to train surgical technologists.

https://precision-surgical.net/

00:00 Welcome and Guest Intro

00:57 Why PSR Exists

02:54 Independence Roadmap

06:23 Fractional Back Office

07:50 Billing Rules by State

12:04 No Noncompete Model

13:25 Dictation Gets You Paid

17:59 Pricing and Transparency

20:21 Facility Contracts Strategy

29:07 Weekly Pay and Denials

33:36 All Starz Risk Model

36:49 Outsourcing Billing Risk

37:20 Op Note Denials Basics

37:57 No Gatekeeping Support

39:10 Fees and Payer Mix

40:29 How Onboarding Works

42:04 Profit Sharing Teams

44:27 Reimbursement Nuances

46:21 Turnkey Practice Setup

49:23 Owner Mindset Required

52:56 Transparency and Responsiveness

54:54 Future Grants Pipeline

58:32 Hard Work and Processes

01:04:05 Contact and Next Steps

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.

Kelly and John discuss John’s experience attending the Maddox Trauma Critical Care and Acute Care Surgery Conference and the Medical Disaster Response conference in Las Vegas, highlighting why these events are valuable for surgical assistants. John shares meeting Dr. Kenneth Maddox and keynote speaker Dr. Frank Butler, and explains how the conference offers cutting-edge trauma, acute care, and disaster-response education, panel Q&As, vendor innovations, and substantial CE opportunities. They cover practical logistics and cost-saving strategies such as early registration, requesting discounted rates, hotel deals, possible hospital reimbursement, and combining the trip with a vacation. John also notes key takeaways like ransomware preparedness, AI in the OR, ongoing debates such as REBOA, and recommends a reusable bowel suturing simulator from LifeLike BioTissue for at-home practice.

For Information on the Mattox Conference:

https://www.trauma-criticalcare.com/

For Lifelike 2 layer Bowel Simulated Tissue:

https://lifelikebiotissue.com/

John interviews co-host Kelly about her experience at the recent joint ASA/NSAA conference in Atlanta, which sold out with 173 attendees and over 200 including vendors. Kelly explains the typical conference flow, from Friday registration and optional pre-conference workshops to the State of the Association updates and keynote, followed by Saturday’s scientific sessions, vendor hall networking, and raffles. She shares highlights including a stapling technologies workshop with historical devices, standout vendor products like the SYLK incision dressing, and impactful talks on complex deformity correction, colorectal surgery, bariatric duodenal switch, wound closure principles, and neurosurgical considerations. Kelly notes strong professional energy, cross-mingling between organizations, progress toward unification under the American Academy of Surgical Assistants, and announces next year’s conference in Tampa, April 16–17, 2027.