Minimally invasive surgery, or endoscopic surgery is an alternate surgical technique to the conventional open technique in general surgery, such as for gall bladder removal, hernia repair, and appendectomy. It requires surgeons to operate using an endoscope and specially designed endoscopic tools. The instrumentation for this technique imposes additional visual, spatial, tactual and motoric constraints on the surgeons.

This exploratory study, examining three laparoscopic procedures, Cholecystectomy, Appendectomy, and Fundoplication, is based on a human-centred, information processing approach. The task analysis included an analysis of selected surgical tasks, and the endoscopic manipulators used, as well as a survey of the surgeons' views about the tasks and tools. Dissecting, suturing, knotting, and cutting tasks were decomposed into subtasks and analyzed by timeline and motion analysis. Scissors, graspers and needle drivers/holders were analyzed and evaluated for their usability. User feedback on all three aspects of the study (user, task, and tool) were obtained through personal interviews, and a questionnaire survey of registered general surgeons in British Columbia, Canada.

Task analysis results and user feedback agreed that suturing and knotting are the most difficult tasks in laparoscopic surgery. Surgeons require more time and movements to suture and tie knots than other tasks. Surgeons also considered the needle drivers/holders that were used for these tasks to be more difficult than other tools to use. As tools were evaluated with respect to the task requirements, the perceived difficulty in using the tools was associated with both the physical and information processing constraints arising from performing the tasks. Surgeons' performance of basic surgical skills reflect these constraints. Remote manipulation in laparoscopic surgery exhibits the characteristic motions of natural human prehension, such as reaching and grasping. However, contrary to the parallel arrangement of transport and grasp components in direct manipulation, the results of motion analysis suggest that these reaching and grasping components are organized serially for remote manipulation in endoscopic surgery.