Understanding errors during laparoscopic surgery.

Complications may occur during laparoscopic surgery, even with a skilled surgeon and under ideal circumstances; human error is inevitable. Videotaped procedures from malpractice cases are evaluated to ascertain potential contributing cognitive factors, systems errors, equipment issues, and surgeon training. Situation awareness and principles derived from aviation crew resource management may be adapted to help avoid systems error. The current process of surgical training may need to be reconsidered.