title: Laparoscopic training model using fresh human cadavers without the establishment of penumoperitoneum.
abstract: BACKGROUND
  Laparoscopy is a well-established alternative to open surgery for treating many diseases. Although laparoscopy has many advantages, it is also associated with disadvantages, such as slow learning curves and prolonged operation time. Fresh frozen cadavers may be an interesting resource for laparoscopic training, and many institutions have access to cadavers. One of the main obstacles for the use of cadavers as a training model is the difficulty in introducing a sufficient pneumoperitoneum to distend the abdominal wall and provide a proper working space. The purpose of this study was to describe a fresh human cadaver model for laparoscopic training without requiring a pneumoperitoneum.
  
  
  RESULTS
  A fake abdominal wall device was developed to allow for laparoscopic training without requiring a pneumoperitoneum in cadavers. The device consists of a table-mounted retractor, two rail clamps, two independent frame arms, two adjustable handle and rotating features, and two frames of the abdominal wall. A handycam is fixed over a frame arm, positioned and connected through a USB connection to a television and dissector; scissors and other laparoscopic materials are positioned inside trocars. The laparoscopic procedure is thus simulated.
  
  
  CONCLUSIONS
  Cadavers offer a very promising and useful model for laparoscopic training. We developed a fake abdominal wall device that solves the limitation of space when performing surgery on cadavers and removes the need to acquire more costly laparoscopic equipment. This model is easily accessible at institutions in developing countries, making it one of the most promising tools for teaching laparoscopy.
authors.affiliation: Department of Gastrointestinal Surgery, Hospital das Clínicas of University of São Paulo, São Paulo, Brazil.
authors.forename: Ernesto Sasaki
authors.initials: ES
authors.lastname: Imakuma
authors.affiliation: Department of General Surgery, Universitray Hospital of University of São Paulo, São Paulo, Brazil.
authors.forename: Edson Yassushi
authors.initials: EY
authors.lastname: Ussami
authors.affiliation: Department of Gastrointestinal Surgery, Liver Unity (LIM37), Hospital das Clínicas of University of São Paulo, São Paulo, Brazil; Abdominal Wall Repair Center, Samaritano Hospital, São Paulo, Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: Meyer
keywords: Cadaver; laparoscopy; teaching