TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator
The Laparoscopic Diaphragmatic Repair Simulator is a trainer built from locally available materials — a disposable surgical mask stretched across a cardboard support inside a laparoscopic box trainer — for practising laparoscopic repair of a traumatic diaphragmatic laceration.[1] Learners create a defect in the taut mask "diaphragm" and close it using intracorporeal suturing and knot tying.
| Field | Details |
|---|---|
| Features and Basic Operation | Learners create a laceration in the taut mask diaphragm and repair it using intracorporeal suturing and knot tying. Looped rubber bands provide adjustable downward tension on the base strut. Metal nosebands removed from two masks are divided and used as four corner fasteners. Towels, cloth or previously used masks can be placed beneath the diaphragm as a generic visual prop for sub-diaphragmatic viscera; the source does not identify a specific organ or tissue represented by that prop. |
| Current Development Status | Developer-published ALL-SAFE penetrating-thoracoabdominal-trauma module on the ALL-SAFE box-trainer platform. The consortium publishes validation evidence for the box-trainer platform and for its Ectopic Pregnancy and Appendectomy modules; the available validation record does not report a separate validation study for this diaphragmatic-repair module.[3] |
| Estimated Build Time and Cost | - - |
| Specialized Tools and Equipment | Build tools identified by the ALL-SAFE instructions: box cutter, utility knife, or #11 scalpel; ruler; and pencil. For training use, the laparoscopic box trainer and laparoscopic instruments for intracorporeal suturing are required. These use-time instruments are shared training equipment rather than components of the tissue module. |
| 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, and Mbingo Baptist Hospital — developed through the Global Surgical Training Challenge. |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Diaphragm | 1 mask body; 2 masks are used when the additional noseband fasteners are included | Disposable surgical mask | - | The stretched body of one disposable mask represents the diaphragm. Metal nosebands removed from two masks are cut in half to make four reusable corner fasteners. The nosebands are fixation components and do not represent diaphragm tissue. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Box-trainer body | 1 | Cardboard box | - | Provides the host enclosure. Slits are cut in the sides and back to install and tension the mask-support assembly. This is structural support, not an anatomical surrogate. |
| Base strut | 1 | Cardboard | - | 43 cm × 3.8 cm (17 in × 1.5 in) strip that supports the mask diaphragm. Corrugation should run across the short dimension where possible. |
| Tension system | 2 rubber bands | Rubber bands | - | The two bands are looped together and attached between the base strut and the rear of the box to apply downward tension. They are structural fixation components and have no anatomical target. |
| Mask corner fasteners | 4 | Metal nosebands removed from 2 disposable surgical masks | - | Each noseband is cut in half. The four resulting pieces pass through the mask corners and into the cardboard corrugation to secure the simulated diaphragm. They can be reused for multiple trials. |
| Tape | As needed | Tape | - | Secures the folded ends of the base strut and can supplement mask tension if required. |
| Sub-diaphragmatic prop | As needed | Towels or cloth; discarded masks can also be reused | - | Placed at the bottom of the box beneath the simulated diaphragm to provide a generic visual representation of underlying viscera. The source does not assign this prop to any specific organ or tissue, so no anatomy relationship is created. |
Build Instructions
The following construction sequence follows the ALL-SAFE module and its source-linked penetrating-trauma build instructions.[2]
Phase 1: Prepare the box
Step 1. Cut a straight strip of cardboard to 43 cm × 3.8 cm (17 in × 1.5 in). Where possible, orient the cardboard corrugation across the 3.8 cm dimension. This strip is the base strut.
Step 2. Loop two rubber bands together.
Step 3. Cut two 1.3 cm (0.5 in) slits in the back of the box and make a hole at the end of each slit. Space the slits approximately 7 cm (2.75 in) apart near the centre of the base of the rear panel. The source states that these dimensions do not need to be exact; they need only allow the rubber-band tension system to be secured.
Step 4. Tie one end of the joined rubber-band pair around the base strut near its centre.
Step 5. Cut a 2 cm (0.8 in) slit in each side of the box.
Step 6. Slide the base strut through the two side slits.
Step 7. Fold the projecting ends of the cardboard strip downward and secure them with tape.
Step 8. Secure the free end of the rubber-band assembly through the rear slits. This applies downward pressure to the base strut and allows diaphragm tension to be adjusted.
Source checkpoint: at this stage, compare the box assembly with the source images below.
Phase 2: Prepare the mask diaphragm
Step 1. Cut off the string or elastic ends from one disposable mask, including the attached sections at the folded edges.
Step 2. Extend the mask by pulling its upper and lower edges until the pleated body becomes a flat rectangle.
Step 3. Remove the metal noseband from two disposable masks.
Step 4. Cut both metal nosebands in half to produce four fastening pieces. The source notes that these pieces can be reused for multiple trials and that noseband design can vary between mask brands.
Step 5. Push one metal piece through each corner of the flattened mask approximately 1.5 cm (0.59 in) from the edge.
Step 6. Fold each metal piece back on itself to hold it in the mask material.
Step 7. Repeat this process for all four mask corners.
Phase 3: Install the diaphragm
Step 1. Push the four metal-band attachments into the cardboard corrugation of the support assembly. Keep the mask taut between the upper two attachment points.
Step 2. Bend the metal fasteners back into the corrugation to secure the mask to the cardboard.
Step 3. Repeat for all four corners.
Step 4. If vertical mask tension is insufficient, reposition the two lower metal fasteners higher through the mask material. If horizontal tension is insufficient, use tape to improve fixation.
Phase 4: Create the traumatic defect
Step 1. Create a horizontal defect in the mask measuring 50.8 mm (2 in).
The source record identifies the 50.8 mm measurement from the annotation on the corresponding build photograph rather than from the running instructional text.
Phase 5: Add the sub-diaphragmatic prop
Step 1. Place towels or other cloth material at the required height in the bottom of the box beneath the simulated diaphragm. Previously used masks can also be repurposed for this role.
Source limitation: the ALL-SAFE instructions use this material to model underlying "vital organs" or viscera but do not identify a particular organ or anatomical tissue. Do not assign the prop to a specific anatomy target.
End product
Digital resources
- Video: Build Instructions — YouTube, 3:38
- Video: Platform Demo — Vimeo
- Build Instructions PDF
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 |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator". Appropedia. Retrieved September 12, 2026. |
- ↑ ALL-SAFE Consortium. "Penetrating Thoracoabdominal / Traumatic Diaphragmatic Injury Module", Global Surgical Training Challenge. ALL-SAFE/Laparoscopic Diaphragmatic Repair and ALL-SAFE/Laparoscopic Diaphragmatic Repair/Simulation.
- ↑ ALL-SAFE Consortium. "Penetrating Trauma Simulation: Build Instructions." Penetrating Thoracoabdominal / Traumatic Diaphragmatic Injury module, Global Surgical Training Challenge. Build Instructions PDF, linked from ALL-SAFE/Laparoscopic Diaphragmatic Repair/Simulation.
- ↑ ALL-SAFE Consortium. "Validation Evidence." Global Surgical Training Challenge. ALL-SAFE/Validation Evidence. The page identifies detailed validation evidence for platform feasibility, Module 1 (Ectopic Pregnancy), and Module 2 (Appendectomy).