Ergonomics of task performance in endoscopic surgery

Abstract

Ergonomics is the scientific study of people at work in terms of workplace layout, equipment design, the work environment, safety, productivity and training. Ergonomics is based on multiple disciplines such as anatomy, physiology, psychology and engineering combined in a systems approach. The ergonomic approach has been used in industry and the military to improve the safety and productivity of the work environment. By contrast in surgical practice, morbidity and mortality are used as an index of safety but this approach does not address adequately the causation of surgical complications or the measures that increase efficient delivery of surgical care. Since 1995 there has been widespread use of endoscopic surgical techniques in almost all surgical specialities, and the laparoscopic approach has become the gold standard management of many surgical disorders. Both industry and surgeons have responded positively to the new endoscopic era. The medical technology industry has developed and marketed a whole range of new endoscopic instrumentation and video equipment, while surgeons have developed or modified existing techniques and, more recently, instituted measures to audit the benefit, safety and impact of the new endoscopic surgical management. This rapid advancement of endoscopic surgery has encountered and still faces some problems. Most of the endoscopic equipment and instruments in current usage are adaptations from other areas of technology and from open surgery without adequate considerations to the demands of endoscopic techniques. The ergonomic layout of the current operating theatres, designed for conventional open practice, is also not ideal for the needs of endoscopic surgery where a variety of high technology ancillary devices are necessary for the conduct of endoscopic interventions. Despite the increasing complexity of these technologies used in the operating theatre, ergonomic progress and design has laggednnn behind these developments. Only a few surgeons maintain interest in recent advances in medical technology and in ergonomic studies. © Springer-Verlag Berlin Heidelberg 2008.