Quantitative standardised analysis of advanced laparoscopic surgical procedures.

Abstract

To support the improvement of advanced laparoscopic surgical procedures, we designed a quantitative analysis method to monitor surgical activities. The emphasis lies on the time spent on these activities and on the instruments controlled by the hands of the surgeon. Our method uses combined video images originating from the laparoscope, an overview CCD camera placed in the operating theatre and, when available, a video colonoscope. After the operation is finished, the images are evaluated by means of a standardised analysis routine based on a spreadsheet program and a set of standard terms (thesaurus), to minimise subjectivity of the analysis. After calculations, the data are presented in tables and graphs, resulting in objective information for research on the operation. Seven advanced laparoscopic procedures, in this case colon resections, have been analysed, and it was demonstrated that the analysis method is capable of describing different laparoscopic procedures using the limited thesaurus. Possible areas of application of the method are the evaluation of time-consuming parts of the operation, of surgical tasks and measurement of the surgeon's learning curve. Other applications are the prediction and measurement of the impact of new instruments and techniques.