title: Problems with laparoscopic instruments: opinions of experts.
abstract: BACKGROUND
  Laparoscopic surgery is particularly known for its complex technique, which calls for operative analysis of laparoscopic instruments. This study investigates the opinion of experts about clinical problems with instruments occurring during laparoscopic surgery.
  
  
  METHODS
  A questionnaire was used to obtain the opinions of expert laparoscopic surgeons about difficulties experienced operatively using laparoscopic instruments.
  
  
  RESULTS
  The laparoscopic surgeons indicated that coagulators were especially prone to cause complications of the gastro-intestinal tract, vascular injuries, and bile duct injuries. Dissectors were considered to play a role in the occurrence of solid organ and bile duct injuries, and retractors to cause solid organ injuries. Insufficient functionality of the instruments and insufficient quality of the image were indicated to contribute to the instrument's risks.
  
  
  CONCLUSIONS
  The questionnaire identified technological deficiencies prone to cause operative complications. The results provide a basis for the interaction between surgeons and engineers, and serve as pilot information on which to base an in-depth object evaluation of instrument problems.
authors.affiliation: Delft University of Technology, Design, Engineering, and Production, Mekelweg, The Netherlands. j.dankelman@wbmt.tudelft.nl
authors.forename: K T
authors.initials: KT
authors.lastname: den Boer
authors.forename: T
authors.initials: T
authors.lastname: de Jong
authors.forename: J
authors.initials: J
authors.lastname: Dankelman
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
mesh_terms: D004210:Dissection / Q000295:instrumentation; D004564:Electrocoagulation / Q000295:instrumentation; D006801:Humans; D020706:Laparoscopes; D009339:Needles; D013525:Surgical Instruments; D011795:Surveys and Questionnaires; D014465:Ultrasonics