TissueDB/Simulators/Laparoscopic Box Trainer Simulator

The Laparoscopic Box Simulator is a low-cost laparoscopic skills trainer built from cardboard and other locally available materials, used to practise instrument handling, hand-eye coordination, and trocar placement. The ALL-SAFE Consortium developed the simulator for surgical training in low-resource settings.^[1]

Download and print these resources before starting:

• PDF of box trainer build instructions (v11.6)
• PDF of measurement templates — draw templates manually
• PDF of templates for A4 paper
• PDF of templates for US Letter paper

Video instructions:

• YouTube: Build instructions
• Vimeo: Platform demo

Print all cutting templates (Parts A, B, C, D, E). Two template files are available: one for A4 paper and one for US Letter paper. Use the file that matches the printer's paper size.

Print settings: 100% scale, no borders or margins. A small white border can remain on printed sheets; cut this off so the template dimensions remain correct. Tape the pages together to form the full-size templates.

Step 1. Use straight pins to secure the paper templates onto the pieces of cardboard.

Step 2. Mark each piece with its corresponding letter (A, B, C, D, E). Use a box cutter, utility knife, or scalpel and a ruler to cut out each template until all six pieces are ready for assembly.

Reference photos: Marking and cutting

Part A — side walls, make 2:

Cut two pieces, each from cardboard measuring at least 8.5" (215 mm) × 14" (355 mm).

Cut the general shape shown in the template.

The light-source window at the top is optional unless required by a target module. Its size can be adjusted.

Use a scalpel to cut the thin angled slit.

Part B — front wall:

Cut from cardboard measuring at least 8.5" (215 mm) × 14" (355 mm).

Cut the shape according to the template.

Cut the slit for Part E.

Create the indicated holes.

Loop three rubber bands together and thread the resulting strand through both holes.

Part C — back wall:

Prepare Part C from cardboard measuring at least 8.5" (215 mm) × 14" (355 mm).

The measurement template defines Part C as approximately 354 mm × 215 mm.

The two stabilization-flap slots are required only when the optional stabilization system is installed.

Part D — top:

Cut from cardboard measuring at least 14" (355 mm) × 10.5" (250 mm).

Corrugation direction is important. Orient the corrugation front-to-back as shown below. This orientation is required if the Penetrating Trauma target tissue module will be installed.

Cut the rectangular light-source window when required for that target module.

Use a scalpel to cut the thin slit for Part E.

Part E — angled phone stand:

Cut from cardboard measuring at least 8.5" (215 mm) × 14" (355 mm).

Cut the general shape with a box cutter.

Use a scalpel to cut the laparoscopic tool holes, middle slot and upper rectangular cutouts.

The centre rectangular opening can be enlarged for a larger smartphone.

Loop two rubber bands together.

Place one rubber band in the upper rectangular cutouts for phone retention.

Use tape to attach both Part A pieces to Part C.

Part A forms the side walls and Part C forms the back wall.

Both Part A pieces must be assembled on the inside of Part C.

Tape the outside and inside corners.

Loop three rubber bands together to form a strand.

Thread the strand through both holes in Part B.

Tie the rubber-band strand with a normal knot.

Place Part E into the corresponding slits in Parts B and D.

Part E forms the angled phone/work surface.

Part B is the front wall and Part D is the top.

Place the side tabs of Part E into the corresponding angled slits in both Part A pieces.

Part D sits on top of Parts A and C.

Both Part A pieces attach to the inside of Part B.

Tape the components together.

Place the smartphone into the rubber-band retention system on Part E.

The smartphone supplies the internal laparoscopic camera view.

Two viewing modes provide different camera angles.

Zero-degree (0°) view

Place the smartphone flat on Part E with its screen facing the user and the camera pointing into the rectangular opening.

The phone rests against the upper lip of Part B.

Adjust the phone and target module until the required view is obtained.

Thirty-degree (30°) view

Stretch the free rubber band from the top of Part E around the smartphone vertically.

Lower the smartphone into the rectangular opening in Part E.

Use the rubber bands attached to Part B to secure the phone.

Adjust the phone and target module until the required view is obtained.

If additional stability is required, two cardboard flaps can anchor the enclosure to the floor or table.

1. Cut two slots in Part B. Each slot is approximately 5 mm wide. Space the two slots 110 mm apart and centre them on the front of the box.
2. Cut two slots in Part C. Each slot is approximately 5 mm wide. Space them 130 mm apart and centre them on the rear of the box. The wider rear spacing is required if the Penetrating Trauma module will be installed.
3. Cut two cardboard pieces, each 192.4 mm × 340 mm (7.57" × 13.77").
4. Orient the cardboard corrugation parallel to the 340 mm dimension.
5. Bend each piece 40 mm from one end.
6. Insert the bent tab of one flap into the Part B slot pair and the other into the Part C slot pair.
7. Place weights on the flaps or tape the flaps to the working surface to prevent movement during use.

The enclosure itself contains no target-tissue representation.

The following modules are separate builds that can be placed inside the box:

• ectopic pregnancy;
• appendectomy;
• Meckel's diverticulum;
• penetrating thoracoabdominal trauma;
• trocar placement; and
• gallbladder disease.

The materials of those target modules must remain on their own simulator records and must not be attributed to the box enclosure.

When the trainer is used, the enclosure constrains instrument access in a way that can serve an Abdominal Wall-type operative constraint.

This is a functional training interpretation, not a material-anatomy mapping.

Therefore:

• Cardboard does not represent Abdominal Wall.
• Tape does not represent anatomy.
• Rubber bands do not represent anatomy.
• Paper templates do not represent anatomy.
• Straight pins do not represent anatomy.
• The smartphone does not represent anatomy.
• All source material-use relationships on this enclosure remain non-anatomical.

The ALL-SAFE v11.6 build instructions do not state a source build cost.

Previous US-dollar values for cardboard, rubber bands, tape, pins, tools and the approximate US$15 total were editorial retail estimates. They are not retained in the canonical Cost field or material rows.

No total build time is stated in the source.