Jain Mayank, Tantia Om, Khanna Shashi, Sen Bimalendu, Sasmal Prakash Kumar
Department of Minimal Access Surgery, ILS Multispecialty Clinic, Kolkata, India.
J Laparoendosc Adv Surg Tech A. 2009 Aug;19(4):535-40. doi: 10.1089/lap.2008.0384.
Repair of groin and ventral hernias are among the technically difficult endoscopic procedures where the role of laparoscopic surgery is fast emerging. We have designed a laparoscopic simulator trainer box for hernia surgery, which closely mimics the complex endoscopic procedure, and good results can be achieved by training on these trainer boxes.
The endotrainer box was self-designed to repair bilateral groin hernia, and an incisional hernia, such that it can be used for multiple repairs. Forty candidates were trained with the trainer box for 2 days over two hernia training programs, and an objective assessment of the result was done by global and task-specific scoring for transabdominal preperitoneal (TAPP) and intraperitoneal onlay mesh (IPOM) repair of groin and incisional hernia, respectively.
There was a significant improvement in the global (10.15 on day 1 and 12.85 on day 2) and task-specific score for TAPP (3.55 on day 1 and 5.83 on day 2) and IPOM repair (4.4 on day 1 and 6.4 on day 2).
Cheaper endotrainer boxes can be self-designed for complex endoscopic surgeries such as hernia repair. The training with these trainer boxes under the supervision of experienced surgeons shows good results and can be used for surgical residents and practicing surgeons who are exposed to basic laparoscopic skills.
腹股沟疝和腹疝修补术属于技术难度较大的内镜手术，腹腔镜手术在其中的作用正在迅速显现。我们设计了一种用于疝手术的腹腔镜模拟器训练箱，它能紧密模拟复杂的内镜手术，通过在这些训练箱上进行训练可取得良好效果。
自行设计的内镜训练箱可用于双侧腹股沟疝和切口疝的修补，从而可用于多种修补手术。40名学员在两个疝修补训练项目中使用该训练箱进行了为期2天的训练，并分别通过对腹股沟疝和切口疝的经腹腹膜前修补术（TAPP）及腹腔内置片修补术（IPOM）进行整体评分和特定任务评分，对结果进行了客观评估。
整体评分（第1天为10.15，第2天为12.85）以及TAPP修补术（第1天为3.55，第2天为5.83）和IPOM修补术（第1天为4.4，第2天为6.4）的特定任务评分均有显著提高。
对于诸如疝修补这类复杂的内镜手术，可自行设计价格较为低廉的内镜训练箱。在经验丰富的外科医生指导下使用这些训练箱进行训练，效果良好，可用于外科住院医师以及已掌握基本腹腔镜技能的执业外科医生。
