Archives of Gynecology and Obstetrics

, Volume 298, Issue 4, pp 773–779 | Cite as

Instrument usage in laparoscopic gynecologic surgery: a prospective clinical trial

  • Lisa StotzEmail author
  • Ralf Joukhadar
  • Amr Hamza
  • Fabinshy Thangarajah
  • David Bardens
  • Ingolf Juhasz-Böss
  • Erich-Franz Solomayer
  • Marc P. Radosa
  • Julia C. Radosa
General Gynecology



To evaluate instrumental usage in laparoscopic gynecological surgeries and to develop key timesets of a laparoscopic operation, which allows categorization of the operation time into different sections.


In this prospective clinical observational study, frequency of instrument usage, time for instrument switches, and instrument utilization time were recorded in a standardized manner for laparoscopic surgeries in 103 endoscopic surgeries.


A standard equipment (including atraumatic grasping forceps, irrigation and suction device, bipolar clamp, and laparoscopic scissors) was used for nearly all interventions. Bipolar clamps and scissors were changed most frequently. The tool used for the longest amount of time was the atraumatic grasping forceps. Laparoscopic instruments were switched 51 times per surgery (range 2–250 times). One instrument switch lasted for a median of 0.13 min (0.08–1.2 min). Median time for instrument switch for a single surgery added up to 6.83 min. Instrument switches required 10.5% of the overall operation time.


We analyzed the current instrument usage in laparoscopic gynecological surgeries. The results of our standardized investigation suggest ways to reduce the time required for surgery and provide starting points for the standardization of the work routine.


Laparoscopy Endoscopy Gynecologic surgery Surgical instruments Operation time 


Author contributions

LS: project development, data collection, and manuscript writing. RJ: project development. AH: data collection, and study design. DB: data analysis. IJ-B: study design. E-FS: project development. MPR: study design. JR: project development, and manuscript writing.

Compliance with ethical standards

Conflict of interest

The author declare that they have no conflict of interest

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standard of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Lisa Stotz
    • 1
    Email author return OK on get
  • Ralf Joukhadar
    • 1
    • 2
  • Amr Hamza
    • 1
  • Fabinshy Thangarajah
    • 4
  • David Bardens
    • 1
  • Ingolf Juhasz-Böss
    • 1
  • Erich-Franz Solomayer
    • 1
  • Marc P. Radosa
    • 3
  • Julia C. Radosa
    • 1
  1. 1.Clinic for Gynecology, Obstetrics and Reproductive MedicineSaarland University Medical CenterHomburgGermany
  2. 2.Clinic for Gynecology and PolyclinicWürzburg University Medical CenterWürzburgGermany
  3. 3.Department for GynecologyDiaconia Clinic KasselKasselGermany
  4. 4.Department of Obstetrics and GynecologyUniversity of Cologne, Medical FacultyCologneGermany

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