INSTRUMENTS AND EQUIPMENTS
|Year : 2010 | Volume
| Issue : 1 | Page : 3-5
The basket trainer: A homemade laparoscopic trainer attainable to every resident
Department of Urology, Dammam Medical Complex, Saudi Arabia
|Date of Submission||24-Nov-2009|
|Date of Acceptance||18-Mar-2010|
|Date of Web Publication||15-Apr-2010|
PO box 2825, Dammam 31461
Source of Support: None, Conflict of Interest: None
Laparoscopic trainers have been proved to be effective to improve skills of laparoscopic surgery; they are usually installed at hospital in the surgical department with limited access hours, usually inconvenient to the schedule of the resident. Simple trainer boxes are necessary for residents who desire developing their skills at home independently to the venue and hours of surgical departments. Our goal is to bring the laparoscopic trainer to the desktop of the surgical resident by making it very cheap, small, light, secure and easy to construct. We describe a model of laparoscopic trainer using steel basket which, we believe, meets all of the above-mentioned requirements. It is accessible to any personal budget and can be constructed with a minimum of hand skill. It is small and light enough to permit its daily use on the desktop of the resident for a couple of hours, then after it can be stocked in any locker.
Keywords: Laparoscopic trainer, laparoscopic simulator
|How to cite this article:|
Jaber N. The basket trainer: A homemade laparoscopic trainer attainable to every resident. J Min Access Surg 2010;6:3-5
| ¤ Introduction|| |
Laparoscopic trainers were designed to help with training in basic laparoscopic skills and to assist surgeons in getting acquainted with instruments. ,, Numerous commercial virtual-reality and non-virtual trainers are available; however, since these trainers are costly they are unattainable by most surgical departments. Simple trainer boxes are necessary for the departments with limited budget and for residents who desire developing their skills at home independently to the venue and hours obliged by their departments. They have to be secure, small, and light enough to permit their displacement frequently and everywhere. The construction has to be easy, using cheap constituents and accessible in the markets anywhere in the world. They have to provide strong points of entry, while permitting a minimal freedom of movements. since the ideal angle of action and depth are not always easy to obtain in real practice of laparoscopic surgery, the ideal trainer has to provide a choice of several points of entry which permits a variable distance from entry to the target (10-25 cm) and a variable angle of action. A wide range of materials can be used to construct the box. Plywood, plaster of Paris, plastic box and desk drawer were previously used. ,,, We describe a new trainer based on the use of a metallic basket. Our goal is to bring the laparoscopic trainer to the desktop of the surgical resident by making it very cheap, small, light, secure and easy to construct.
| ¤ Methods|| |
The parts that are required to build this trainer cost roughly only $41. As we will show in this section, nearly everyone should be able to construct it.
Other than the constituents in [Table 1], a drill and a screw driver are necessary for the construction.
- Assembling the box: The basket we use for our trainer is a runner drawer designed by Elfa® for customized shelving and drawer system. It is robust and light, made of strong epoxy-bonded steel and available in showrooms and through internet (cost: 14 US$) [Figure 1]. An acrylic sheet is used as a base for the box (polycarbonate and plywood sheets may also be used). Use a drill and screw driver to install the two hinges on both the basket and the acrylic sheet on one side only [Figure 2]. No lock is necessary for the opposite side since the basket will drop down over the acrylic sheet by its weight.
- Attaching the camera : Any web camera in the market is suitable given it can be attached by a clamp to the ruler previously introduced through the eyes of the basket in a high and posterior position and fixed by tape [Figure 3]. In our early experience we used a web camera with incorporated light (cost: 13 USD), but we quickly realized that we do not need any light source since the basket permits the passage of enough light for excellent vision. Optional upgrading, naturally more costly, may include high definition camera, digital zoom, auto focus, motorized tracking or a colour surveillance camera connected to a screen.
- Preparing the points of entry: A rubber sheet (or a rubbery mouse pad) is attached over the top of the basket by tape. By its position, it will prevent the direct vision of the target. It will also permit by its elasticity the degree of freedom necessary for the point of entry [Figure 4].
- Preparing the working area: A cork sheet is fixed to the acrylic sheet by glue UHO® . The piece of tissue to be sutured (or anyother convenient material) may be attached to the cork sheet by pins.
No computer is included. Every trainee will pose his personal laptop over the basket and fix it by a Velcro® hook and loop tape [Figure 4]
- Instructions for use
- Connect your laptop to the camera.
- Install the driver using the provided CD (This is unnecessary for plug and play cameras)
- Adjust the direction, focus and zoom of the camera.
- Put the laptop over the box and fix it by Velcro® hook and loop Strap.
- Choose the suitable points of entry on the mouse pad and make the desired holes by knife or trocars.
- Introduce your instruments and start training.
| ¤ Discussion and Conclusion|| |
A new simple laparoscopic trainer is described. It is cheap and easy to construct for most of surgery residents, small and light enough to permit its daily use on the desktop at home. This basket trainer will permit to overcome the difficulties due to the unavailability of trainers in the hospital or their limited access hours by bringing the laparoscopic trainer to the desktop of the surgical resident.
The characteristics of our model compared to previously described trainers are as follows:
- Time to construction: 30 min.
- No need for hand skill. It is mainly a simple assembly,
- All the constituents are readily available in the market are ready to use.
- The epoxy-bonded steel basket is strong and light, it permits a free passage of light and air making the use of light source unnecessary and providing an excellent security with no risk of overheating or electrical shortcut.
- No direct vision is possible since the rubber sheet stays in the axe of vision.
- Overall weight of the trainer (without laptop) is 1400 g.
- Dimensions: 55 × 35 × 29 cm.
- Overall cost: 41 US$ (laptop not included).
| ¤ References|| |
|1.||Gue S. Home-made videoscopic trainer for operative laparoscopic surgery. Aust N Z J Surg 1995;65:820-1. [PUBMED] |
|2.||Blacker AJ. How to build your own laparoscopic trainer. J Endourol 2005;19:748-52. [PUBMED] [FULLTEXT] |
|3.||Ricchiuti D, Ralat DA, Evancho-Chapman M, Wyneski H, Cerone J, Wegryn JD. A simple cost-effective design for construction of a laparoscopic trainer. J Endourol 2005;19:1000-2. [PUBMED] [FULLTEXT] |
|4.||Robert G, Calvet C, Lapouge O, Vallee V, Emeriau D, Ballanger P. Development and validation of a model of training at home to the laparoscopy. Prog Urol 2006;16:352-5. [PUBMED] |
|5.||Laguna MP, de Reijke TM, Wijkstra H, de la Rosette J. Training in laparoscopic urology. Curr Opin Urol 2006;16:65-70. [PUBMED] [FULLTEXT] |
|6.||Rassweiler J, Klein J, Teber D, Schulze M, Frede T. Mechanical simulators for training for laparoscopic surgery in urology. J Endourol 2007;21:252-62. [PUBMED] [FULLTEXT] |
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]
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