Abstract
Background
Data on man-machine interfaces in the operation theater are essential to the improvement of surgical efficiency. This study analyzed the activity of the operating team during laparoscopic cholesystectomy by surgical trainees.
Methods
The endoscopic image and overview of the operating room were recorded during 20 laparoscopic cholecystectomies performed by specialist residents. Time-motion analysis of the recorded tapes was performed.
Results
The median (interquartile range [IQR]) for theater time was 134± min (IQR, 52 min). The components of operative time for the surgeon were 26% for insertion of access ports and wound closure, 57% for intracorporeal endoscopic work, and 17% for instrument change. Only 52% of the scrub nurse time was related to the operation. Machine and video setup, adjustment of ancillary equipment together, and delivery of instruments and items requested by the surgeon and scrub nurse accounted for 13% of the circulating nurse time.
Conclusions
With the current nonergonomic theater design and structure, a significant proportion of theater time during routine uncomplicated laparoscopic surgery is used for nonoperative functions. The study highlights the need for improved ergonomic design, integrated bus operating systems under the control of the surgeon, and multifunctional laparoscopic instruments.
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References
Bhatnager V, Drury CG, Schiro SG (1985) Posture, postural discomfort, and performance. Hum Factors 27: 189–199
Claus GP, Sjoerdsma W, Jansen A, Grimbergen CA (1995) Quantitative standardised analysis of advanced laparoscopic surgical procedures. Endosc Surg Allied Technol 3: 210–213
den Boer KT, Straatsburg IH, Schellinger AV, de Wit LT, Dankelman J, Gouma DJ (1999) Quantitative analysis of the functionality and efficiency of three surgical dissection techniques: a time-motion analysis. J Laparoendosc Adv Surg Tech A 9: 389–395
Hanna GB, Shimi S, Cuschieri A (1997) Optimal port locations for endoscopic intracorporeal knotting. Surg Endosc 11: 397–401
Hanna GB, Shimi SM, Cuschieri A (1998) Randomised study of influence of two-dimensional vrrsus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet 351: 248–251
Haslegrave CM (1994) What do we mean by a “working posture”? Ergonomics 37: 781–799
Kenyon TA, Lenker MP, Bax TW, Swanstrom LL (1997) Cost and benefit of the trained laparoscopic team: a comparative study of a designated nursing team vs a nontrained team. Surg Endosc 11: 812–814
Liao MH, Drury CG (2000) Posture, discomfort, and performance in a VDT task. Ergonomics 43: 345–359
Mallet J (2001) Studying man machine interfaces in the operating room. Minim Invasive. Ther Allied Technol 10: 133–137
Nathanson LK, Shimi S, Cuschieri A (1991) Laparoscopic chole-cystectomy: the Dundee technique. Br J Surg 78: 155–159
Ponsky JL (1991) Complications of laparoscopic cholecystectomy. Am J Surg 161: 393–395
Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, Schwartz JS, Williams SV (1996) Mortality and complications associated with laparoscopic cholecystectomy: a meta-analysis. Ann Surg 224: 609–620
Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992) Laparoscopic cholecystectomy: the new “gold standard”? Arch Surg 127: 917–921
Traverso LW, Hargrave K (1995) A prospective cost analysis of laparoscopic cholecystectomy. Am J Surg 169: 503–506
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Geryane, M.H., Hanna, G.B. & Cuschieri, A. Time-motion analysis of operation theater time use during laparoscopic cholecystectomy by surgical specialist residents. Surg Endosc 18, 1597–1600 (2004). https://doi.org/10.1007/BF02637127
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DOI: https://doi.org/10.1007/BF02637127