Hierarchical decomposition of complex behaviour and systems is a valuable research methodology from human factors and information-processing psychology that can be applied to laparoscopic surgery. This article describes results of research on surgeons performing several different laparoscopic procedures, conducted in Vancouver, Canada 1995–98. Through top-down analyses of surgical procedures and bottom-up analyses of tool motions, results included detailed decomposition of the procedures through surgical steps, sub-steps, tasks, sub-tasks and tool motions. Analyses at all levels provided valuable information. In addition to specific surgeon- and technology-related observations, such as the effect of dividing the short gastrics on performance of Nissen fundoplication, gaze patterns of surgeons and factors related to patient safety were analysed. The hierarchical decomposition approach can be extended to other aspects of the complex system that consists of the surgeon and operating room team, the technologies and the operating room environment. Other frameworks for assessment are also considered.

A questionnaire soliciting the experience and opinions of surgeons of different specialties regarding Minimally Invasive Surgery (MIS) was used to gauge the present and future state of MIS. The questionnaire was sent to over 1000 surgeons in the province of British Columbia, Canada. Results are summarized highlighting different aspects of MIS including demographics, procedures performed constraints and possible solutions for the constraints of the surgical procedures performed by general and specialty surgeons. The look-ahead reveals the attitudes of surgeons toward future technologies and techniques.

All creators of copyright-protected works are re-assessing the protection and exploitation of their works in the digital environment. This article attempts to define 'digital' in a copyright context. It reminds artists and photographers of the essentials of copyright as they already apply in the UK before it looks at how those essentials may apply to images circulating in the digital environment. Finally it covers some of the key issues which artists and other creators are now having to address in their day to day work.