Laparoscopic Trainer with Pneumoperitoneum

José L. Ortiz Simón, Arturo Minor Martínez, Neftalí Prado Coronado, Ricardo Ordorica Flores

Bioelectronics Section, Center for Research and Advanced Studies of the IPN, México DF, México.
Department of Electrical and Electronics Engineering, Technological Institute of Nuevo Laredo, Nuevo Laredo, México.
Pediatrics Section, Federico Gómez Children’s Hospital, México DF, México.

DOI: 10.4236/ss.2012.310099                

Abstract

The development of skills and abilities in laparoscopy is directly related to the use of trainers. The trainer should model the patient with all its natural complexities as closely as possible. In this article we propose a system for training the establishment of pneumoperitoneum executing the basic tasks to create the workspace in the trainer, the insertion of primary umbilical trocar and simulate some of the everyday problems in surgery. Materials and Methods. A group of electrical with biomedical engineers and laparoscopic surgeons developed a physical trainer that allows implementing the pneumoperitoneum. The system uses pneumatic electro valves that are controlled with a dedicated microprocessor. The user can program the system to set the parameters of the pneumoperitoneum. Results. This new trainer facilitated the programming of right values of parameters to distend the abdominal cavity according a specific clinical case. The model developed enables the trainee to consolidate his knowledge on establishing the parameters required within clinical practice, as well as the entry techniques. Conclusions. A new physical model for laparoscopic training was designed. The system enables the laparoscopic surgeon to set the parameters for establishing the workspace according to the clinical case. The trainer allows the surgeon to train in the Hasson technique for the introduction of the first trocar, as well as the placement of the rest of surgical instruments with video assistance. We think this new trainer system will help minimize entry-related injuries.

Keywords

Laparoscopy; Trainer; Pneumoperitoneum

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	R. Katz, “Methods of Training Using Pelvic Trainers,” Current Urology Reports, Vol. 7, No. 2, 2006, pp. 100-106. doi:10.1007/s11934-006-0067-0
[2]	M. P. Laguna, H. Wijkstra, “Volume 11: Training in Laparoscopy,” In: J. J. M. C. H. de la Rosette and I. S. Gill, Eds., Laparoscopic Urologic Surgery in Malignancies, Springer, New York, 2005, pp. 260-261.
[3]	M. P. Laguna, T. M. de Reijke and J. J. de la Rosette, “How Far Will Simulators be Involved into Training?” Current Urology Reports, Vol. 10, No. 2, 2009, pp. 97-105. doi:10.1007/s11934-009-0019-6
[4]	K. Madan and C. T. Frantzides. “Prospective Randomized Controlled Trial of Laparoscopic Trainers for Basic Laparoscopic Skills Acquisition,” Surgical Endoscopy, Vol. 21, No. 2, 2007, pp. 209-213. doi:10.1007/s00464-006-0149-6
[5]	J. Schleef, “Chapter 8: Complications of Endoscopic Surgery in Infants and Children,” In: Endoscopic Surgery in Infants and Children, Springer, New York, 2008, pp. 66-67.
[6]	G. A. Vilos, “The ABCs of a Safer Laparoscopic Entry,” Journal of Minimally Invasive Gynecology, Vol. 13, No. 3, pp. 249-251. doi:10.1016/j.jmig.2005.12.005
[7]	G. A. Vilos, A. G. Vilos, B. Abu-Rafea, J. Hollett-Caines, Z. Nikkhah-Abyaneh and F. Edris, “Three Simple Steps during Closed Laparoscopic Entry May Minimize Major Injuries,” Surgical Endoscopy, Vol. 23, No. 4, 2008, 758-764 .
[8]	T. Fujimoto, O. Segawa, G. J. Lane, S. Esaki and T. Miyano, “Laparoscopic Surgery in Newborn Infants,” Surgical Endoscopy, Vol. 13, No. 8, 1999, 773-777. doi:10.1007/s004649901096
[9]	T. N. Pappas and A. M. Fecher. “Principles of Minimally Invasive Surgery,” Surgery, Sec. 4, 2008, pp. 771-790.
[10]	D. S. Beebe, S. Zhu, M. V. S. Kumar, V. Komanduri, J. A. Reichert and K. G. Belani, “The Effect of Insufflation Pressure on CO2 Pneumoperitoneum and Embolism in Piglets,” Anesthesia & Analgesia, Vol. 94, No. 5, 2002, pp. 1182-1187. doi:10.1097/00000539-200205000-00024
[11]	C.-G. Schmedt, O. Heupel, V. Riemer and C. N. Gutt, “Insufflation Profile and Body Position Influence Portal Venous Blood Flow during Pneumoperitoneum,” Surgical Endoscopy, Vol. 17, No. 12, 2003, pp. 1951-1957. doi:10.1007/s00464-002-9244-5
[12]	A. K. Saxena, “Chapter 6: Effects of insufflation,” In: A. K. Saxena and M. E. H?llwarth, Eds., Essentials of Pediatric Endoscopic Surgery, Springer, New York, 2008, pp. 59-62.
[13]	T. Cakir, D. Tuney, S. Esmaeilzadem and A. O. Aktan, “Safe Veress Needle Insertion,” Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 13, No. 3, 2006, pp. 225-227. doi:10.1007/s00534-005-1024-x
[14]	H. Steyaert and J. S. Valla. “Chapter 47: Laparoscopic Appendectomy in Children.” In: A. K. Saxena and M. E. Hollwarth, Eds., Essentials of Pediatric Endoscopic Surgery, Springer, New York, 2008, pp. 342-343.
[15]	A. K. Bell, M. Zhou, S. D. Schwaitzberg and C. G. L. Cao, “Using a Dynamic Training Environment to Acquire Laparoscopic Surgery Skill,” Surgical Endoscopy, Vol. 23, No. 10, 2009, pp. 2356-2363. doi:10.1007/s00464-009-0346-1