McCrory Bernadette, LaGrange Chad A, Hallbeck Ms
Mechanical and Materials Engineering Department, University of Nebraska, Lincoln, NE, USA.
Division of Urologic Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Biomed Eng Comput Biol. 2014 Apr 21;6:1-11. doi: 10.4137/BECB.S10967. eCollection 2014.
Adverse events because of medical errors are a leading cause of death in the United States (US) exceeding the mortality rates of motor vehicle accidents, breast cancer, and AIDS. Improvements can and should be made to reduce the rates of preventable surgical errors because they account for nearly half of all adverse events within hospitals. Although minimally invasive surgery (MIS) has proven patient benefits such as reduced postoperative pain and hospital stay, its operative environment imposes substantial physical and cognitive strain on the surgeon increasing the risk of error. To mitigate errors and protect patients, a multidisciplinary approach is needed to improve MIS. Clinical human factors, and biomedical engineering principles and methodologies can be used to develop and assess laparoscopic surgery instrumentation, practices, and procedures. First, the foundational understanding and the imperative to transform health care into a high-quality and safe system is discussed. Next, a generalized perspective is presented on the impact of the design and redesign of surgical technologies and processes on human performance. Finally, the future of this field and the research needed to further improve the quality and safety of MIS is discussed.
在美国，医疗差错导致的不良事件是主要死因，其死亡率超过了机动车事故、乳腺癌和艾滋病。应该并且能够做出改进以降低可预防的手术差错发生率，因为手术差错在医院所有不良事件中占近一半。尽管微创手术（MIS）已证明对患者有益，如减轻术后疼痛和缩短住院时间，但其手术环境给外科医生带来了巨大的身体和认知压力，增加了出错风险。为了减少差错并保护患者，需要采用多学科方法来改进微创手术。临床人为因素以及生物医学工程原理和方法可用于开发和评估腹腔镜手术器械、操作和程序。首先，讨论了将医疗保健转变为高质量和安全系统的基本理解和必要性。接下来，从广义角度介绍了手术技术和流程的设计与重新设计对人类表现的影响。最后，讨论了该领域的未来以及进一步提高微创手术质量和安全性所需的研究。
