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 built and field-deployed by the ALL-SAFE consortium on a validated box-trainer platform; no validation study specific to the diaphragmatic-repair (penetrating thoracoabdominal trauma) module is published. |
| Estimated Build Time and Cost | US$5 (estimated) |
| 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 |
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 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) 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 |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Laparoscopic Diaphragmatic Repair Simulator". Appropedia. Retrieved July 14, 2026. |