title: Time-action analysis of laparoscopic procedures - input for clinically driven instrument design.
abstract: Clinically driven instrument development aims at reducing clinically important problems of the surgical process. The input for clinically driven instrument design originates in the difficulties that occur during the peroperative process. This paper describes a method of time&#150;action analysis as a tool to provide input for designers. Four steps can be distinguished in the process of clinically driven instrument development: (1) assessment of the instrument-related difficulties during operations; (2) the translation of the clinical problems into technical design specifications; (3) the construction of a prototype; (4) the evaluation of the prototype. Time&#150;action analysis can be used to detect the difficulties of the operative process in detail, supporting Step 1 of the clinically driven development process. In addition, it can be used to evaluate objectively the efficiency and limiting factors of new prototypes in comparison to currently available instruments (Step 4).