Table 1.

The Leiden Surgical Rating Scale (L-SRS)

1	Extremely poor conditions: The surgeon is unable to work due to coughing or due to the inability to obtain a visible laparoscopic field because of inadequate muscle relaxation. Additional neuromuscular blocking agents must be given.
2	Poor conditions: There is a visible laparoscopic field but the surgeon is severely hampered by inadequate muscle relaxation with continuous muscle contractions and/or movements with the hazard of tissue damage. Additional neuromuscular blocking agents must be given.
3	Acceptable conditions: There is a wide visible laparoscopic field but muscle contractions and/or movements occur regularly causing some interference with the surgeon's work. There is the need for additional neuromuscular blocking agents to prevent deterioration.
4	Good conditions: There is a wide laparoscopic working field with sporadic muscle contractions and/or movements. There is no immediate need for additional neuromuscular blocking agentsunless there is the fear for deterioration.
5	Optimal conditions: There is a wide visible laparoscopic working field without any movement or contractions. There is no need for additional neuromuscular blocking agents.