Preliminary Comparison of Laparoendoscopic Single-Site Surgery Instrumentation With Novice Surgical Interns: How Usability Testing Can Reveal Human Factors Issues Prior to Errors in the Operating Room¹

The technical challenges of laparoendoscopic single-site surgery (LESS) stem from the nonideal instrument configuration in which all of the instrumentation is inserted through a single small incision and are greater than those faced when using conventional laparoscopy (CL). LESS configuration results in more instrument collisions, an in-line view of the instruments, and the surgeon's close proximity to assistants [1–3]. These limitations of LESS procedures and its related technologies that, along with possible increased physical risk to the surgeon, currently limit the standardization and universal adoption of this pioneering technique [4]. Minimally invasive surgery (MIS) which includes LESS is very appealing to the patient for the immediate outcomes including reduced scarring and recovery time [5–8]. Scarring in LESS is isolated to one incision within the umbilicus compared to four small incision scars resulting from CL. Although both types of surgery offer advantages to the patient,...