Please use this identifier to cite or link to this item:
Title: Hierarchical task analysis for identification of interrelationships between ergonomic, external disruption, and internal disruption in complex laparoscopic procedures.
Authors: Sengupta, Shomik
Other Authors: Al-Hakim, Latif
Wang, M.
Xiao, J.
Gyomber, D.
Keywords: Disruption
Ergonomic Requirements
Hierarchical Task Analysis
Laparoscopic Radical Prostatectomy
Performance Appraisal
Training Aid
Ergonomic Goals
Surgical Teams
Internal Disruptive Events
External Disruptive Events
General Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: 2019
Publisher: Springer
Citation: Surg Endosc. 2019 Jan 30.
Abstract: BACKGROUND: Traditionally, hierarchical task analysis (HTA) in surgery examines observable disruption in a predefined set of tasks as performed, rather than examining the ergonomics requirements, which may predispose surgical teams to act erroneously. This research aims to address this gap in the literature. It develops a HTA protocol taking into consideration surgical team actions, observable external disruption, internal disruption, and ergonomic goals required for safer conducting procedures. Laparoscopic radical prostatectomy (LRP) is selected as a case. METHODS: This research involved observations inside operating rooms (ORs) of three large teaching hospitals in Australia and China. Two rounds of observations are conducted: observations for developing HTA, and observations after presenting the developed HTA among surgical teams. The traditional HTA format is expanded to include two additional columns: technical considerations and ergonomics considerations. Two groups are formed from the observed LRPs. LRPs in the first group were conducted with no regard to the specified ergonomic goals and associated ergonomic features, and the second are conducted with the surgical teams attempting to follow specified ergonomic goals and features as prescribed in HTA. Careful attempt is required to select procedures such that the total operative times for both groups are approximately equal (± 5%). RESULTS: Between March 2016 and November 2017, a total of 29 LRPs were observed, and a HTA developed. The results reveal significant reduction (43%) in the total external disruptive events and approximately 58% reduction in the internal disruptive events in LRPs conducted with HTA requirements. CONCLUSIONS: The developed HTA appears to have some utility, but needs evaluation in larger studies. It can potentially be used as a training aid, and as a checklist for evaluating surgical performance.
DOI: 10.1007/s00464-018-06656-z
PubMed URL:
ISSN: 0930-2794
Journal Title: Surgical Endoscopy
Type: Journal Article
Affiliated Organisations: Department of Service Science and Operations Management, Zhejiang University, Hangzhou, China
Division of Information Technology and Mathematical Sciences, University of South Australia, Adelaide, South Australia
Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Urology Unit, Austin Hospital, Heidelberg, Victoria, Australia
Austin Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
Appears in Collections:General Surgery and Gastroenterology

Files in This Item:
There are no files associated with this item.

Items in Epworth are protected by copyright, with all rights reserved, unless otherwise indicated.