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Quality and safety of minimally invasive surgery: past, present, and future
Bernadette McCrory1, Chad A LaGrange2, Ms Hallbeck3
1Mechanical and Materials Engineering Department, University of Nebraska, Lincoln, NE, USA.
Abstract:
Adverse events because of medical errors are a leading cause of death in the United States (US) exceeding the mortality rates of motor vehicle accidents, breast cancer, and AIDS. Improvements can and should be made to reduce the rates of preventable surgical errors because they account for nearly half of all adverse events within hospitals. Although minimally invasive surgery (MIS) has proven patient benefits such as reduced postoperative pain and hospital stay, its operative environment imposes substantial physical and cognitive strain on the surgeon increasing the risk of error. To mitigate errors and protect patients, a multidisciplinary approach is needed to improve MIS. Clinical human factors, and biomedical engineering principles and methodologies can be used to develop and assess laparoscopic surgery instrumentation, practices, and procedures. First, the foundational understanding and the imperative to transform health care into a high-quality and safe system is discussed. Next, a generalized perspective is presented on the impact of the design and redesign of surgical technologies and processes on human performance. Finally, the future of this field and the research needed to further improve the quality and safety of MIS is discussed.
Insights
Medical errors cause many deaths, with surgical errors being a significant hospital concern. Improving minimally invasive surgery (MIS) through human factors and engineering can enhance patient safety and reduce preventable errors.
Area of Science:
- Medical error analysis
- Surgical safety research
- Human factors engineering
Background:
- Medical errors are a leading cause of death in the US, with preventable surgical errors comprising nearly half of all hospital adverse events.
- Minimally invasive surgery (MIS) offers patient benefits but increases surgeon physical and cognitive strain, heightening error risk.
Purpose of the Study:
- To highlight the need for a multidisciplinary approach to enhance safety in minimally invasive surgery (MIS).
- To explore the application of clinical human factors and biomedical engineering in improving surgical practices and technologies.
- To discuss the impact of surgical technology and process design on surgeon performance and patient outcomes.
Main Methods:
- Reviewing foundational principles for transforming healthcare into a high-quality, safe system.
- Presenting a generalized perspective on the effects of designing and redesigning surgical technologies and processes.
- Identifying future research directions for improving MIS quality and safety.
Main Results:
- Surgical errors contribute significantly to adverse medical events, necessitating improvements in surgical procedures.
- The design of surgical tools and processes directly impacts surgeon performance and the potential for errors.
- A multidisciplinary approach integrating human factors and engineering is crucial for MIS safety.
Conclusions:
- Minimally invasive surgery (MIS) requires enhanced safety protocols due to increased surgeon strain.
- Clinical human factors and biomedical engineering offer methodologies to assess and improve MIS instrumentation and practices.
- Further research is essential to optimize the quality and safety of minimally invasive surgical procedures.
