Comparative Usability Testing of Conventional and Single Incision Laparoscopic Surgery Devices

Department of Biomedical Engineering, University of Nebraska-Lincoln, 342 Nebraska Hall, Lincoln, NE 68588-0526, USA.
Human Factors The Journal of the Human Factors and Ergonomics Society (Impact Factor: 1.29). 06/2013; 55(3):619-31. DOI: 10.1177/0018720812465082
Source: PubMed

ABSTRACT The objective was to perform competitive usability testing to assess the user experience of conventional laparoscopic and laparoendoscopic single-site surgery (LESS) devices.
Recent advancements in single-incision instrumentation have created more interest in and usage of LESS. However, neither LESS nor its novel multichannel access devices have been thoroughly studied.
Using a simulation test bed and standardized laparoscopic surgery task, the user experience of three commercially available LESS devices was compared to conventional laparoscopic ports based on time on task, errors, task success, and perceived ease of use.
There were no significant differences between devices for time on task, errors, or task success (p > .05). For all devices, there were significantly more recoverable than unrecoverable errors, and errors occurred more frequently during the second phase of the task when the dominant hand was more active (p < .0001). Conventional laparoscopy was rated as easier to use than were the LESS devices (p < .01).
Device performance of a basic laparoscopic task was similar in both conventional laparoscopy and LESS. Each of the LESS devices facilitated efficient and accurate aiming and grasping movements compared to conventional laparoscopy. Further investigation of human factors and ergonomics of LESS is needed to further develop, evaluate, and refine single-site surgery technologies to create a user experience equivalent to conventional laparoscopy.
Competitive usability testing of medical devices yields objective performance data that can be used to inform purchase decisions and future device design improvements.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Flank position is extensively used in retroperitoneoscopic urological practice. Most surgeons follow the patients' position in open approaches. However, surgical ergonomics of the conventional position in the retroperitoneoscopic surgery is poor. We introduce a modified position and evaluated task performance and surgical ergonomics of both positions with simulated surgical tasks. Twenty-one novice surgeons were recruited to perform four tasks: bead transfer, ring transfer, continuous suturing, and cutting a circle. The conventional position was simulated by setting an endo-surgical simulator parallel to the long axis of a surgical desk. The modified position was simulated by rotating the simulator 30A degrees with respect to the long axis of the desk. The outcome measurements include task performance measures, kinematic measures for body alignment, surface electromyography, relative loading between feet, and subjective ratings of fatigue. We observed significant improvements in both task performance and surgical ergonomics parameters under the modified position. For all four tasks, subjects finished tasks faster with higher accuracy (p < 0.005 or < 0.001). For ergonomics part: (1) The angle between the upper body and the head was decreased by 7.4 +/- A 1.7A degrees; (2) The EMG amplitude collected from shoulders and left lumber was significantly lower (p < 0.05); (3) Relative loading between feet was more balanced (p < 0.001); (4) Manual-action muscles and postural muscles are rated less fatiguing according to the questionnaire (p < 0.05). Conventional position of patient in retroperitoneoscopic upper urinary tract surgery is associated with poor surgical ergonomics. With a simulated surgery, we demonstrated that our modified position could significantly improve task performance and surgical ergonomics. Further studies are still warranted to validate these benefits for both patients and surgeons.
    Surgical Endoscopy 06/2014; 28(11). DOI:10.1007/s00464-014-3598-3 · 3.31 Impact Factor