Skip to main content
SpringerLink
Log in

Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair

  • Dynamic Manuscript
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

A realistic simulator for transabdominal preperitoneal (TAPP) inguinal hernia repair would enhance surgeons’ training experience before they enter the operating theater. The purpose of this study was to create a novel physical simulator for TAPP inguinal hernia repair and obtain surgeons’ opinions regarding its efficacy.

Methods

Our novel TAPP inguinal hernia repair simulator consists of a physical laparoscopy simulator and a handmade organ replica model. The physical laparoscopy simulator was created by three-dimensional (3D) printing technology, and it represents the trunk of the human body and the bendability of the abdominal wall under pneumoperitoneal pressure. The organ replica model was manually created by assembling materials. The TAPP inguinal hernia repair simulator allows for the performance of all procedures required in TAPP inguinal hernia repair. Fifteen general surgeons performed TAPP inguinal hernia repair using our simulator. Their opinions were scored on a 5-point Likert scale.

Results

All participants strongly agreed that the 3D-printed physical simulator and organ replica model were highly useful for TAPP inguinal hernia repair training (median, 5 points) and TAPP inguinal hernia repair education (median, 5 points). They felt that the simulator would be effective for TAPP inguinal hernia repair training before entering the operating theater. All surgeons considered that this simulator should be introduced in the residency curriculum.

Conclusions

We successfully created a physical simulator for TAPP inguinal hernia repair training using 3D printing technology and a handmade organ replica model created with inexpensive, readily accessible materials. Preoperative TAPP inguinal hernia repair training using this simulator and organ replica model may be of benefit in the training of all surgeons. All general surgeons involved in the present study felt that this simulator and organ replica model should be used in their residency curriculum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Reznick RK, MacRae H (2006) Teaching surgical skills: changes in the wind. N Engl J Med 355:2664–2669

    Article  CAS  PubMed  Google Scholar 

  3. Bokeler U, Schwarz J, Bittner R, Zacheja S, Smaxwil C (2013) Teaching and training in laparoscopic inguinal hernia repair (TAPP): impact of the learning curve on patient outcome. Surg Endosc 27:2886–2893

    Article  PubMed  Google Scholar 

  4. Andresen K, Friis-Andersen H, Rosenberg J (2016) Laparoscopic repair of primary inguinal hernia performed in public hospitals or low-volume centers have increased risk of reoperation for recurrence. Surg Innov 23:142–147

    Article  PubMed  Google Scholar 

  5. Barsness KA, Rooney DM, Davis LM (2013) The development and evaluation of a novel thoracoscopic diaphragmatic hernia repair simulator. J Laparoendosc Adv Surg Tech A 23:714–718

    Article  PubMed  Google Scholar 

  6. Voitk AJ (1998) The learning curve in laparoscopic inguinal hernia repair for the community general surgeon. Can J Surg 41:446–450

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Zahiri HR, Park AE, Pugh CM, Vassiliou M, Voeller G (2015) “See one, do one, teach one”: inadequacies of current methods to train surgeons in hernia repair. Surg Endosc 29:2867–2872

    Article  PubMed  Google Scholar 

  8. Sharma M, Horgan A (2012) Comparison of fresh-frozen cadaver and high-fidelity virtual reality simulator as methods of laparoscopic training. World J Surg 36:1732–1737

    Article  PubMed  Google Scholar 

  9. Kurashima Y, Feldman L, Al-Sabah S, Kaneva P, Fried G, Vassiliou M (2011) A novel low-cost simulator for laparoscopic inguinal hernia repair. Surg Innov 18:171–175

    Article  PubMed  Google Scholar 

  10. Carter J, Duh QY (2011) Laparoscopic repair of inguinal hernias. World J Surg 35:1519–1525

    Article  PubMed  PubMed Central  Google Scholar 

  11. Abdulzahra Hussain JN, El-Hasani Shamsi (2010) Technical tips following more than 2000 transabdominal preperitoneal (TAPP) repair of the groin hernia. Surg Endosc 20:384–388

    Google Scholar 

  12. Trevisonno M, Kaneva P, Watanabe Y, Fried GM, Feldman LS, Lebedeva E, Vassiliou MC (2015) A survey of general surgeons regarding laparoscopic inguinal hernia repair: practice patterns, barriers, and educational needs. Hernia 19:719–724

    Article  CAS  PubMed  Google Scholar 

  13. Sugavanam S, Devarajan V (2003) Simulation of a preperitoneal mesh in laparoscopic herniorrhaphy. Stud Health Technol Inform 94:343–345

    PubMed  Google Scholar 

  14. Kurashima Y, Feldman LS, Kaneva PA, Fried GM, Bergman S, Demyttenaere SV, Li C, Vassiliou MC (2014) Simulation-based training improves the operative performance of totally extraperitoneal (TEP) laparoscopic inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 28:783–788

    Article  PubMed  Google Scholar 

  15. Sanders AJ, Luursema JM, Warntjes P, Mastboom WJ, Geelkerken RH, Klaase JM, Rodel SG, ten Cate Hoedemaker HO, Kommers PA, Verwey WB, Kunst EE (2006) Validation of open-surgery VR trainer. Stud Health Technol Inform 119:473–476

    CAS  PubMed  Google Scholar 

  16. Lapeer RJ, Gasson P, Florens JL, Laycock S, Karri V (2004) Introducing a novel haptic interface for the planning and simulation of open surgery. Stud Health Technol Inform 98:197–199

    PubMed  Google Scholar 

  17. Gopalakrishnan G, Devarajan V (2004) StapSim: a virtual reality-based stapling simulator for laparoscopic hemiorrhaphy. Stud Health Technol Inform 98:111–113

    PubMed  Google Scholar 

  18. Chmarra MK, Dankelman J, van den Dobbelsteen JJ, Jansen FW (2008) Force feedback and basic laparoscopic skills. Surg Endosc 22:2140–2148

    Article  PubMed  Google Scholar 

  19. Choi YH, Lee HW, Lee SY, Han DH, Seo SI, Jeon SS, Lee HM, Choi HY, Jeong BC (2016) Laparoendoscopic single-site simple nephrectomy using a magnetic anchoring system in a porcine model. Investig Clin Urol 57:208–214

    Article  PubMed  PubMed Central  Google Scholar 

  20. Majumder A, Fayezizadeh M, Hope WW, Novitsky YW (2016) Evaluation of a novel permanent capped helical coil fastener in a porcine model of laparoscopic ventral hernia repair. Surg Endosc 30(12):5266–5274

    Article  PubMed  PubMed Central  Google Scholar 

  21. Deeken CR, Matthews BD (2013) Ventralight ST and SorbaFix versus Physiomesh and Securestrap in a porcine model. JSLS 17:549–559

    Article  PubMed  PubMed Central  Google Scholar 

  22. Panaro F, Matos-Azevedo AM, Fatas JA, Marin J, Navarro F, Zaragoza-Fernandez C (2015) Endoscopic and histological evaluations of a newly designed inguinal hernia mesh implant: experimental studies on porcine animal model and human cadaver. Ann Med Surg 4:172–178 (Lond)

    Article  Google Scholar 

  23. Botden SM, Torab F, Buzink SN, Jakimowicz JJ (2008) The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation. Surg Endosc 22:1214–1222

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank all of the participants who voluntarily participated in this study as well as all of the associate developers of the simulator. Funding from the Grant-in-Aid for Epidemiological Research of St. Luke’s International University is gratefully acknowledged.

Author information

Authors and Affiliations

  1. Department of Surgery, National Hospital Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan

    Yuichi Nishihara & Yoh Isobe

  2. Department of Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan

    Yuko Kitagawa

Authors
  1. Yuichi Nishihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoh Isobe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuko Kitagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuichi Nishihara.

Ethics declarations

Disclosure

Yuichi Nishihara received funding from the Grant-in-Aid for Epidemiological Research of St. Luke’s International University and Grant-in-Aid of FASOTEC Co., Ltd. Yoh Isobe received funding from Grant-in-Aid of FASOTEC Co., Ltd. Yuko Kitagawa has no conflicts of interest or financial ties to disclose.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MP4 91,928 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nishihara, Y., Isobe, Y. & Kitagawa, Y. Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair. Surg Endosc 31, 5429–5435 (2017). https://doi.org/10.1007/s00464-017-5614-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-017-5614-x

Keywords

Search

Navigation