TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator

The Laparoscopic Diaphragmatic Repair Simulator is a low-cost trainer built from locally available materials — a disposable mask stretched across a cardboard frame inside a box trainer — for practising the laparoscopic repair of a traumatic diaphragmatic laceration. Learners cut a defect in the mask "diaphragm" and close it with intracorporeal suturing and knot tying, the core skills of laparoscopic management of penetrating thoracoabdominal trauma.

Field	Details
Features and Basic Operation	Learners cut a laceration in the taut mask "diaphragm" and close it with intracorporeal suturing and knot tying inside the box trainer. The looped rubber bands on the base strut adjust diaphragm tautness; the mask's metal nosebands serve across multiple repair attempts, and spent masks can be repurposed as the sub-diaphragmatic "viscera."
Current Development Status	Third-party build, published by the ALL-SAFE consortium as its penetrating thoracoabdominal trauma module on the ALL-SAFE box-trainer platform. The consortium publishes validity evidence for the box trainer and for Module 1 (Ectopic Pregnancy) and Module 2 (Appendectomy), and none for this module.^[1]
Estimated Build Time and Cost	~US$5
Specialized Tools and Equipment	Build tools, per the ALL-SAFE build instructions: a box cutter, utility knife, or #11 scalpel; a ruler; and a pencil. Use-time equipment: the laparoscopic box trainer and its laparoscopic instruments for intracorporeal suturing — shared equipment supplied by the trainee or programme, not part of this module's build cost (the source does not itemise the instruments).
Version	Version 1
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

Source — every material, build step and dimension on this page is drawn from the ALL-SAFE Laparoscopic Diaphragmatic Repair module^[2] and its build-instructions PDF^[3] (Global Surgical Training Challenge / ALL-SAFE Consortium) unless a cell notes otherwise. Per-row costs are May 2026 retail estimates; the source carries no prices.

Tissues

Tissue	Qty	Material	Cost	Notes
Diaphragm	2	Disposable Mask	US$0.20–0.40	One mask's body is stretched flat to form the taut diaphragm; the metal nosebands from both masks, each cut in half, provide the 4 corner fasteners.

Structural Parts

Part Name	Qty	Material	Cost	Notes
Cardboard box	1	Cardboard	—	Host laparoscopic box trainer body; cut side and back slits to mount the frame, and remove the stabilizing flaps during installation. User-supplied box — not costed in this build.
Organ prop	1	Cloth	US$0–2	Towels or cloth at the bottom of the box model the sub-diaphragmatic viscera; discarded masks can be reused for this.
Base strut	1	Cardboard	US$0–1	Horizontal beam the mask frame mounts to; orient the corrugation across the short dimension if possible.
Rubber bands	2	Rubber	US$0.02–0.10	Looped together; provide downward tension on the base strut to adjust diaphragm tautness.
Tape	1 roll	Tape	US$2–4	Secures the folded strut ends and supplements mask tension as needed.

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 base strut and loop rubber bands together

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.

Corrugation orientation on cardboard strip

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.

Fold ends of cardboard strip down and tape

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.

Rubber band placement for downward tension on base strut

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.

Poke metal pieces through corners of mask

Repeat for all 4 corners.

All four corners with metal band attachments complete

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.

Push metal band attachments into cardboard corrugation

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) in the mask as shown, 50.8 mm (2 in) in horizontal length — the dimension is annotated on the build photograph for this step. This is the diaphragmatic injury that learners will repair.

Create defect in mask diaphragm for repair practice

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.

Add cloth at bottom of box to model vital organs

End product:

References

↑ ALL-SAFE Consortium. "Validation Evidence". Global Surgical Training Challenge. ALL-SAFE/Validation Evidence on Appropedia, which states "Detailed validation data from Platform feasibility, Module 1 (Ectopic Pregnancy), Module 2 (Appendectomy) can be found below" and carries a separate box-trainer ease-of-build and usability study.
↑ ALL-SAFE Consortium. "Penetrating Thoracoabdominal / Traumatic Diaphragmatic Injury Module", with its "Simulation" subpage. Global Surgical Training Challenge. ALL-SAFE/Laparoscopic Diaphragmatic Repair and ALL-SAFE/Laparoscopic Diaphragmatic Repair/Simulation on Appropedia.
↑ ALL-SAFE Consortium. "Penetrating Trauma Simulation: Build Instructions", 11 pages, with the sections "Materials Required for Assembly", "Preparation Instructions" and "Assembly Instructions". Penetrating Thoracoabdominal / Traumatic Diaphragmatic Injury module, Global Surgical Training Challenge. Undated; the document carries no author line and no publication date, and its title page names the consortium as the Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital and Mbingo Baptist Hospital. PDF on Appropedia, linked from ALL-SAFE/Laparoscopic Diaphragmatic Repair/Simulation. The 50.8 mm defect length is a red annotation on the step-D photograph on its page 9, not in its running text.

Digital Resources

Video: Build Instructions (YouTube, 3:38)
Video: Platform Demo (Vimeo)
Build Instructions PDF

Simulator data
Alternative names	Penetrating Thoracoabdominal Trauma Simulator Diaphragmatic Injury Repair Simulator Traumatic Diaphragmatic Injury Simulation

Page data
Keywords	laparoscopic diaphragmatic repair, penetrating thoracoabdominal trauma, diaphragmatic injury, intracorporeal suturing, knot tying, box trainer, ALL-SAFE, low-cost surgical simulator
SDG
Authors	Arturopelayo
License	CC-BY-SA-4.0
Language	English (en)
Related	0 subpages, 3 pages link here
Views	10 page views (analytics)
Created	February 13, 2026 by Arturo Pelayo
Last edit	August 17, 2026 by Arturo Pelayo
Cite as	Arturopelayo (2026). "TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator". Appropedia. Retrieved August 23, 2026.
API queries	basic, semantic, html, files, more

[allsafe-validation-1] ALL-SAFE Consortium. "Validation Evidence". Global Surgical Training Challenge. ALL-SAFE/Validation Evidence on Appropedia, which states "Detailed validation data from Platform feasibility, Module 1 (Ectopic Pregnancy), Module 2 (Appendectomy) can be found below" and carries a separate box-trainer ease-of-build and usability study.

[allsafe-trauma-module-2] ALL-SAFE Consortium. "Penetrating Thoracoabdominal / Traumatic Diaphragmatic Injury Module", with its "Simulation" subpage. Global Surgical Training Challenge. ALL-SAFE/Laparoscopic Diaphragmatic Repair and ALL-SAFE/Laparoscopic Diaphragmatic Repair/Simulation on Appropedia.

[allsafe-trauma-build-3] ALL-SAFE Consortium. "Penetrating Trauma Simulation: Build Instructions", 11 pages, with the sections "Materials Required for Assembly", "Preparation Instructions" and "Assembly Instructions". Penetrating Thoracoabdominal / Traumatic Diaphragmatic Injury module, Global Surgical Training Challenge. Undated; the document carries no author line and no publication date, and its title page names the consortium as the Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital and Mbingo Baptist Hospital. PDF on Appropedia, linked from ALL-SAFE/Laparoscopic Diaphragmatic Repair/Simulation. The 50.8 mm defect length is a red annotation on the step-D photograph on its page 9, not in its running text.

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