The aim of this study is to visualize in a scheme all factors that are part of or influence the human-product interaction in minimally invasive surgery (MIS). The factors involved in the interaction are identified and investigated by means of literature studies, product information from producers and retailers, and by observation of MIS procedures. An interaction scheme has been compiled which encompasses the following factors: • A product factor, divided into the surgical functions of image visualization, workspace creation, tissue treatment, tissue assessment, and procedure support. • A human factor, divided into the functions of perception, cognition, and action. • Internal factors (perceptional, cognitive, and action) and external factors (social, political, physical, clinical, and technological) that influence the interaction. Two product examples are used to demonstrate the use of the interaction scheme. The results show that when the design of a product focuses on limited factors, problems arise related to those factors which are not considered. The interaction scheme is a new way to represent the human-product interaction in MIS. It can be used to structure and to gain insight into problems that occur with the use of MIS products. The scheme also elucidates the factors that are involved in the interaction so that they can be considered in product and operating room design.

Minimally invasive surgery is at this moment one of the outstanding developments in surgery. In this type of surgery the actual operation is performed through a number of small incisions in the skin. In the operations special instruments are inserted via trocars, i. e. tubes which allow the surgeon to bring instruments or sensors into the body. The view at the operating field comes from a laparoscope, a camera presenting a two-dimensional image on a monitor. The minimally invasive surgical technique has many potentional benefits for the patients. However, compared to open surgery there are severe disadvantages for the surgeon, such as the loss of three-dimensional visual feed back and proprioception, the disturbed eye-hand coordination, and the poor ergonomic design of the surgical instrumentation, and of the working place. At this moment the differences beween open and minimally invasive surgery can mainly be ascribed to differences in the manual control task. In this paper, the man-machine aspects of the traditional open operation process will be compared with those of the minimally invasive surgery process. Especially the consequences of the restricted perception in minimally invasive surgery will be discussed. Some future developments will be discussed.