Systems technology in the operating theatre: a prerequisite for the use of advanced devices in surgery.

The development of endoscopic techniques has significantly changed surgery. The increasing complexity of devices being used has increased the demand for improved ergonomics and functionality. Since the early 1990s the development of system solutions for the operating room (OR) has been a topic of major interest for surgeons and industry. The first integrated surgical workplace system was introduced by Dornier (Orest) in 1994. Several other solutions are now commercially available. Their common feature is the ability to control the different functions of the individual devices (e.g. high-frequency waves, camera, or insufflation) via remote control systems directly from the operating table. Other developments in OR systems include ergonomic aids for the surgeon, such as a chair dedicated to the functional needs of endoscopic surgery. The chair is powered by electric motors controlled by a foot-pedal joystick and its position can be altered to achieve the desired position in the OR. Also significant in endoscopic surgery was the introduction of robotic technology, namely devices that assist solo-surgery and manipulators for microsurgical instrumentation.