TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator
General Information
This simulator enables surgeons to practice laparoscopic management of a diaphragmatic laceration in a low-cost box trainer. The model develops intracorporeal suturing and knot-tying skills applicable to penetrating thoracoabdominal trauma, using a disposable mask stretched taut across a cardboard frame to simulate the diaphragm.
| Field | Details |
|---|---|
| General Information | Source: ALL-SAFE Laparoscopic Diaphragmatic Repair module. Developed by the ALL-SAFE Consortium (Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital, Mbingo Baptist Hospital) as part of the Global Surgical Training Challenge. The incidence of occult diaphragmatic injury in penetrating thoracoabdominal trauma is as high as 43%. Technical principles taught include diagnostic laparoscopy, retraction, exposure, intracorporeal suturing, and knot tying. |
| Features and Basic Operation | Not stated in source |
| Current Development Status | Pilot-tested |
| Estimated Build Time and Cost | 15–30 minutes build time; USD 2–10 per build |
| Specialized Tools and Equipment | Not stated in source |
| Version | Not stated in source |
| Development Team Contact Information | ALL-SAFE Consortium: Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital, Mbingo Baptist Hospital |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Diaphragm | 2 | Disposable Mask | USD 0.20–0.40 | Extend mask to flat rectangle for diaphragm surface; metal nosebands from 2 masks provide 4 attachment points; create defect for suture repair practice |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Cardboard box | 1 | Cardboard | USD 0–3 | Laparoscopic box trainer body; temporarily remove stabilizing flaps during module installation |
| Organ prop | 1 | Cloth | USD 0–2 | Place towels or cloth at bottom of box to model sub-diaphragmatic viscera; discarded masks reusable for this purpose |
| Base strut | 1 | Cardboard | USD 0–0.50 | Cut strip 43 cm × 3.8 cm (17" × 1.5"); orient corrugation in 3.8 cm direction if possible |
| Rubber bands | 2 | Rubber | USD 0.02–0.10 | Loop together; provide downward tension on base strut for diaphragm tension adjustment |
| Tape | 1 roll | Tape | USD 2–4 | Secure folded strut ends and supplement mask tension as needed |
| Ruler | 1 | Plastic | USD 1–5 | Measure and mark cut lines for the strut (17" × 1.5"), back-of-box slits (0.5"), slit spacing (2.75"), side-of-box slits (0.8"), and mask corner offsets (0.59") |
| Pencil | 1 | Wood | USD 0.50–1 | Mark cut lines on cardboard before scoring |
| Box cutter | 1 | Steel | USD 5–15 | Cut cardboard strut, side slits, back slits, and mask defect; a #11 scalpel is ideal per source |
Build Instructions
Phase 1: Prepare the Box
- Cut a straight strip of cardboard to 43 cm × 3.8 cm (17" × 1.5"). Orient corrugation in the 3.8 cm direction if possible. This is the "base strut." Loop two rubber bands together as shown.
- Cut two slits in the back of the box (part C), each 1.3 cm (0.5"), and poke a hole at the end of each slit. Space the slits approximately 7 cm (2.75") apart at the base of side C, around the center. These dimensions need not be exact — only close enough to secure the rubber band to the back of the box in the upcoming steps.
- Tie two rubber bands together and tie one end around the base strut near the middle.
- Cut a 2 cm (0.8") slit into each side of the box (both parts A). Slide the base strut through both slits as shown.
- Fold the ends of the cardboard strip down and tape to secure.
- Place the rubber band tied around the cardboard strip around the slits from step 2. This puts downward pressure on the base strut for adjusting the tension on the simulated diaphragm.
Checkpoint: At this point the box should look like the images below.
Phase 2: Prepare the Mask
- Cut off the string ends from the mask, ensuring the sections where the mask folds are glued are properly removed.
- Extend the mask by pulling on the top and bottom, resulting in a flat rectangle.
- Remove the metal band from the nose of 2 masks.
- Cut the two metal bands in half as shown. These bands are reusable for multiple trials. Different mask brands may have different metal bands; most will work.
- Poke each metal piece through the four corners of the mask, 1.5 cm (0.59") from the edge, and fold the metal band on itself.
- Repeat for all 4 corners.
Phase 3: Assembly
- Push the metal band mask attachments into the corrugation of the cardboard. Ensure the mask is taut between the two top metal bands.
- Bend the metal bands back into the corrugation on the top side to secure the mask to the cardboard.
- Repeat for all 4 corners. If the mask is not sufficiently taut in the vertical direction, insert the two lower metal bands higher up through the mask material. If horizontal tension is insufficient, use tape to better secure the metal bands.
- Create a defect (laceration) approximately 50.8 mm (2 in) in horizontal length in the mask as shown. This is the diaphragmatic injury that learners will repair.
- Add towels or other cloth material at the appropriate height on the bottom of the box to model vital organs. After multiple runs of the module, discarded masks can be used for this purpose as well.
End product:
Digital Resources
- Video: Build Instructions (YouTube, 3:38)
- Video: Platform Demo (Vimeo)
- Build Instructions PDF
| Alternative names | Penetrating Thoracoabdominal Trauma Simulator Diaphragmatic Injury Repair Simulator Traumatic Diaphragmatic Injury Simulation |
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| Authors | |
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| License | CC-BY-SA-4.0 |
| Cite as | "TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator". Appropedia. 2026. Retrieved June 4, 2026. |