title: Laparoscopic simulation for all: two affordable, upgradable, and easy-to-build laparoscopic trainers.
abstract: BACKGROUND
  Laparoscopic surgery has established itself as the approach of choice for a multitude of operations in general, urological, and gynecological surgery. A number of factors make performing laparoscopic surgery technically demanding, and as such it is crucial that surgical trainees hone their skills safely on trainers before operating on patients. These can be highly expensive. Here, we describe a novel and upgradable approach to constructing an affordable laparoscopic trainer.
  
  
  METHODS
  A pattern was produced to build an upgradable laparoscopic trainer for less than $100. The basic model was constructed from an opaque plastic crate with plywood base, 2 trocars, and 2 pairs of disposable laparoscopic instruments. A laptop, a light emitting diode (LED), and a fixed webcam were utilized to visualize the box interior. An enhanced version was also created, as an optional upgrade to the basic model, featuring a neoprene-trocar interface and a simulated mobile laparoscope.
  
  
  RESULTS
  The described setup allowed trainees to gain familiarity with laparoscopic techniques, beginning with simple manipulation and then progressing through to more relevant procedures. Novices began by moving easy-to-grasp objects between containers and then attempting more challenging manipulations such as stacking sugar cubes, excising simulated lesions, threading circular mints onto cotton, and ligating fastened drinking straws. These techniques have introduced the necessity of careful instrument placement and have increased trainees' dexterity with laparoscopy.
  
  
  CONCLUSIONS
  Here, we have outlined an upgradable and affordable alternative laparoscopic trainer that has given many trainees crucial experience with laparoscopic techniques, allowing them to safely improve their manual skill and confidence.
authors: Brighton and Sussex Medical School, University of Sussex, Brighton, East Sussex BN1 9PX, United Kingdom. M.Smith1@uni.bsms.ac.uk
authors: Matthew D
authors: MD
authors: Smith
authors: Joseph M
authors: JM
authors: Norris
authors: Lyudmila
authors: L
authors: Kishikova
authors: David P
authors: DP
authors: Smith
mesh_terms: D003365:Costs and Cost Analysis; D004503:Education, Medical, Graduate / Q000191:economics / Q000379:methods; D010535:Laparoscopy / Q000191:economics / Q000193:education*; D008953:Models, Anatomic