Surgical Assistant

After reviewing your medical history, and needed surgical procedure, your surgeon will determine if it is medically necessary for an assistant to be a part of your care team. Many complex surgeries require an additional, specifically trained surgical assistant to ensure the safest care and best outcomes. Often, hospitals require a qualified surgical assistant to be present during a procedure as part of their facility policies.
Surgical first assistants can have a variety of different training backgrounds. Nurse Practitioners and Physician Assistants can function in this role with additional surgical training or fellowships. Registered nurses who have surgery nursing experience can complete a surgical first assisting program to become Registered Nurse First Assistants (RNFAs). In addition, surgical scrub technicians, who complete additional training programs, and obtain licensure can utilized as Licensed Surgical Assistants or LSAs. First assistants of all titles must compete a rigorous and thorough background screening to be credentialed and operate at each hospital. They also work under the direct supervision of a surgeon during surgical procedures and have annual review processes in place to ensure high standards of care.
The first assistant’s role is to facilitate your surgical procedure in all aspects for both the surgeon and surgical team. Before your surgery, they will review your medical history and discuss your procedure with the surgeon. During your procedure they will collaborate with the surgical team regarding your specific case needs, ensure all needed supplies and equipment are readily available, and help safely position you for the procedure after you are asleep. The first assistant will then work alongside the surgeon during the surgical procedure to help provide exposure, hemostasis, and any other surgical techniques needed to proceed in the safest and most efficient manner. For robotic surgeries, the surgeon is operating at the console for most of the procedure, and the first assistant’s role is to remain the patient bedside and manage the operative field as well as operate through their own laparoscopic ports. First assistants are specifically trained on the complexities of robotic procedures as well as open and laparoscopic procedures. Most surgeons work with the same surgical assistants on all cases to ensure consistent, safe care and maximize efficiency.

Urology Clinics of North Texas utilizes many types surgical first assistants.  Each first assistant has been vetted for clinical expertise, safety, and educational background.  Some of these assistants are independent practitioners, employees of surgical assisting groups or employees of UCNT.  Your specific surgical assistant will be determined by the following factors:

  • Surgeon preference
  • Assistant availability on preferred surgery date
  • Hospital location and facility assistant credentialing

Independent and surgical group first assistants have their own billing practices.  The majority of surgical first assistants are out of network with insurance plans for a variety of reasons.  Historically, insurance plans do not negotiate fair market reimbursable rates requiring first assistants to remain out of network.  These first assistants are required by UCNT to work within the following requirements:

  • Provide the patient with advanced notice or letter (for non-emergent cases) of their insurance network status or if they are a cash pay provider only
  • What the out of pocket cost will be for your procedure and offer payment plan options if needed
  • Follow state and federal regulatory requirements regarding billing practices and balance billing laws.
  • Comply with the Federal No Surprise Act (link to bill)

Please visit for more information about your rights regarding “surprise billing”.

Urology Clinics of North Texas

UCNT will be closed for the Thanksgiving Holiday on
Thursday 11/23 & Friday 11/24

We at Urology Clinics of North Texas would like to wish you a very Happy Thanksgiving Holiday! We will return to normal Business hours on Monday, November 27, 2023.