The Use of Audio in Minimal Access Surgery

In minimal access surgery (MAS) (also known as minimally invasive surgery), operations are carried out by making small incisions in the skin and inserting special apparatus into potential body cavities through those incisions. Laparoscopic MAS procedures are conducted in the patient’s abdomen. The aim of MAS is faster recovery, shorter hospitalisation and fewer major post-operative complications; all resulting in lower societal cost with better patient acceptability. The technique is markedly dependent on supporting technologies for vision, instrumentation, energy delivery, anaesthesia, and monitoring. However, in practice, much MAS continues to take longer and be associated with an undesirable frequency of unwanted minor (or occasionally major) mishaps. Many of these difficulties result precisely from the complexity and mal-adaptation of the additional technology and from lack of familiarity with it. A survey of South East England surgeons showed the two main stress factors on surgeons to be the technical difficulty of the procedure and time pressures placed on the surgeon by third parties. Many of the problems associated with MAS operations are linked to the control and monitoring of the equipment. This paper describes work begun to explore ergonomic enhancements to laparoscopic operating technology that could result in faster and safer laparoscopic operations, less surgeon stress and reduce dependence on ancillary staff. Auditory displays have been used to communicate complex information to users in a modality that is complementary to the visual channel. This paper proposes the development of a control and feedback system that will make use of auditory displays to improve the amount of information that can be communicated to the surgeon and his assistant without overloading the visual channel. Control of the system would be enhanced by the addition of voice input to allow the surgeon direct control.