Using a Trainer for Lift Laparoscopic Surgeries to Practice Essential Skills

By Dr. J. Gnanaraj and Dr. A. Awojobi

The introduction of anesthesia made surgeries painless and made complex surgical procedures possible. Similarly, the advent of laparoscopic surgery has made surgeries less invasive or minimally invasive. The use of gasless laparoscopy and conventional instruments was proposed as the next phase of minimally invasive surgery in the early nineties (1). Single-incision surgeries became popular, but they were difficult to master with regular laparoscopic surgical techniques, and then single incision lift laparoscopic surgeries were introduced (2).

A Canadian study found that 10% of the world’s population receives 90% of the surgical resources (3). A presentation at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) concluded that low- and middle-income countries can provide laparoscopic surgery safely and effectively, but it is often limited in availability and quality, and my require more innovation to overcome the challenges. (4). Several cost-effective methods have been described for making laparoscopic surgery available for the poor (5).

Gasless or lift laparoscopic surgery is a method that has the advantages of sturdy instruments and lower costs, and it is easier to learn. The lift laparoscopic trainer is designed to help non-laparoscopic surgeons practice and master basic laparoscopic skills like tying knots and suturing, while becoming accustomed to the less tactile feeling and modified field of vision. All these are in a bid to make it easier when operating on a patient.

Method

As with other laparoscopic trainers, we did not intend to simulate an operation, but only to allow surgeons to practice laparoscopic tasks. The trainer lets them get used to working with a narrow field of vision on a TV screen without the depth perception of direct vision, and with limited tactile feedback (6, 7). This is also similar to beginning residents practicing suturing and tying outside of the operating room, as they can practice intracorporeal suturing knot-tying inside the trainer (8).
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