Problems with technical equipment during laparoscopic surgery. An observational study.
BACKGROUND
This study was designed to investigate the incidence of technical equipment problems during laparoscopic procedures.


METHODS
A video-capturing system was used, consisting of an analog video recorder with three camera image inputs and a microphone. Problems with all technical equipment used by the surgical team, such as the insufflator, diathermy apparatus, monitors, light source, camera and camera unit, endoscope, suction devices, and instruments, were registered.


RESULTS
In total, 30 procedures were randomly videotaped. In 87% (26/30) of the procedures, one or more incidents with technical equipment (49 incidents) or instruments (9 incidents) occurred. In 22 of those incidents (45%) the technical equipment was not correctly positioned or not present at all; in the other 27 (55%), the equipment malfunctioned as a result of a faulty connection (9), a defect (5), or the wrong setting of the equipment (3). In 10 (20%) cases the exact cause of equipment malfunctioning was unclear.


CONCLUSIONS
The incidence of problems with laparoscopic technical equipment is high. To prevent such problems, improvement and standardization of equipment is needed, combined with the incorporation of checklist use before the start of a surgical procedure. Future research should be aimed at development, implementation, and evaluation of these measures into the operating room.
Verdaasdonk
E G G
EG
Department of Surgery, Reinier de Graaf Group, Delft, The Netherlands. e.g.g.verdaasdonk@3me.tudelft.nl
Stassen
L P S
LP
van der Elst
M
M
Karsten
T M
TM
Dankelman
J
J
D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation*; D002983:Clinical Competence; D015331:Cohort Studies; D004868:Equipment Failure; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000453:epidemiology*; D020706:Laparoscopes / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D016896:Treatment Outcome; D014741:Video Recording