Gregory Fu, Vishnu Ganesan, Brian Slakter, Jennifer Snow, MD, Enrico Danzer, MD, Gregg Lipschik, MD, Kristoffel Dumon, MD, Noel Williams, MD, Andrew Resnick, MD MBA FACS. University of Pennsylvania School of Engineering and Applied Science, University of Pennsylvania Department of Medicine,University of Pennsylvania Department of Surgery
Laparoscopic surgery is ubiquitous in the operating room. As first the 80 hour workweek and now additional regulations decrease the training opportunities for residents, simulation training is becoming not just important but critical for surgical education. A range of laparoscopic simulators have been developed to meet this challenge with costs ranging from $50 to $30,000. The majority of the low-cost laparoscopic simulators have an important drawback in that they are unable to simulate the insufflation of the abdomen with CO2 that routinely takes place in the operating room. Mimicking surgical insufflation is necessary to fully prepare surgeons for life-like settings and the potential complications they may offer. Furthermore, for procedures such as laparoscopic ventral hernia repair, insufflation and abdominal curvature are key factors. We have developed a design for a simulator which is low-cost and allows surgeons control over the level of insufflation.To achieve simulated insufflation, we proposed using an electric scissor lift whose extension can be controlled via a remote source. The scissor lift will be placed between two wooden chassis. The outer chassis will function as a support device, while the inner chassis represents the abdominal cavity. A skin-like foam material covers the top of the outer chassis. When the lift is activated, the inner chassis with arched support beams rises, pushing up against the cover. This mimics abdominal insufflation by generating curvature from a flat surface. As with other low-cost simulators of this class, the surgeon can then train on the device by introducing ports through the surface.An earlier, similar prototype was built with a rigid abdominal arch. It was well-received and is currently being used for laparoscopic training. The new dynamic prototype builds on this previous design by incorporating the ability to insufflate and deflate, allowing the user to actively control the height and curvature. This new simulator is in the process of being built and will shortly be tested.The ability to insufflate in low-cost laparoscopic simulators increases both their realism and teaching value. In the future we hope to correlate the level of insufflation with a simulated pressure reading to further improve simulator training.
Session: Emerging Technology Poster
Program Number: ETP043