Ergonomics and design of laparoscopic instruments: results of a survey among laparoscopic surgeons.

This study determined which types of laparoscopic instruments are most often used in Europe, why they are being used, and what problems exist while using the instruments. The handles were also evaluated according to ergonomic design criteria. A questionnaire was send to 62 experienced surgeons in 19 countries. The laparoscopic instruments were divided into four groups: instruments with similar functionality and handgrip model were grouped together. Eight questions were asked for every group about the type of instrument (disposable, reusable, or semireusable), the type of handle, the reason for using a specific instrument, and the experience of discomfort while using the instrument. The handles of the instruments of the group that were associated with the greatest discomfort were ergonomically evaluated on eight aspects (dimensions, angles, and control). Half of the questionnaires were returned. In every group, about 80% of the instruments the surgeons employed were reusable. The chief reason for using a specific type was the good cost-quality of the product and satisfying experiences with other products of the brand. The discomfort was pressure on thumb and fingers (scissors handle) and fixating the tip (ratchet). The handle of the instruments that causes the most discomfort met only three of the eight ergonomic requirements. Most of the laparoscopic instruments employed by surgeons in Europe are reusable. A significant number of the instruments cause discomfort. These instruments do not meet standard ergonomic requirements.