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TissueDB/Simulators/Laparoscopic Inguinal Hernia Repair Simulator (Hanssen)

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Indirect (lateral) hernia model (left side) showing the pork-chop substrate with painted-white transverse process as Cooper's ligament, blue and red electric wires as epigastric and spermatic vessels, condom as indirect hernia sac, 9.5 Fr central venous catheter segment as vas deferens, and 30 Fr polyethylene hoses as iliac vessels. Image by Hanssen et al. (2022), CC BY 4.0.

This simulator is a low-cost laparoscopic inguinal hernia repair training model, built from locally available materials, for rehearsing the trans-abdominal pre-peritoneal (TAPP) repair.[1] It is built around a pork chop that preserves the hemi-vertebra and its transverse process to stand in for Cooper's ligament. Electric wires and polyethylene hoses stand in for the vessels, a central venous catheter segment for the vas deferens, and a condom for the indirect hernia sac.

Field Details
Features and Basic Operation The model lets a trainee rehearse the complete TAPP repair of an indirect inguinal hernia: creating the peritoneal flap, dissecting the pre-peritoneal space to the critical view of the myopectineal orifice, dissecting and ligating the hernia sac, deploying and fixing the mesh, and closing the peritoneal flap. Two models are placed side by side to represent both inguinal regions, the model can be arranged for any inguinal-region hernia type, and a completed model can be reused for up to 24 hours under refrigeration.
Current Development Status Built and pilot-tested in a single-centre validation study with 10 surgical residents; not yet independently replicated.
Estimated Build Time and Cost ~US$20
Specialized Tools and Equipment Building the model needs a number 11 scalpel blade to punch the 2 cm deep-orifice hole, silicone glue to fix the condom and the cord structures to the chop, and white paint to mark the transverse process as Cooper's ligament. Performing the repair also needs a 10 × 12 cm polypropylene mesh, titanium helical fasteners (Protack, Medtronic) for mesh fixation, and a monofilament suture for intra-corporeal closure.
Version Version 1
Development Team Contact Information Developed by Andres Hanssen, Diego A. Hanssen, Rafael A. Hanssen, Sergio Plotnikov, Jose Haddad, and Jorge E. Daes. Lead institution: Clínica Iberoamérica / Universidad Metropolitana, Barranquilla, Colombia, with collaborators at Bronx Care Health System (New York, USA), Wilhelmsburg Groß-Sand Hospital (Germany), Instituto Médico La Floresta (Caracas, Venezuela), and Clínica Portoazul (Barranquilla, Colombia). Correspondence: Andres Hanssen (anhanssen@gmail.com).

The validation study analysed indirect (lateral) hernia repair only, although the authors note the model can be arranged to simulate any type of inguinal-region hernia. Each model takes residents about 25 minutes to prepare, compared with the several hours reported for the McGill Laparoscopic Inguinal Hernia Simulator (MLIHS, Kurashima et al. 2011[2]). The materials are accessible at any supermarket, butcher shop, hardware store, or hospital. The endo-trainer that hosts the model is a separate, assumed-available purchase — any commercial or improvised endo-trainer works — and is not part of the materials cost.

Tissues

Tissue Qty Material Cost Notes
Inguinal region 1 (pork chop) Pork chop preserving the hemi-vertebra and its transverse process; the transverse process is painted white to represent Cooper's ligament. — Biological substrate gives realistic tissue handling, especially for mesh fixation.
Spermatic cord 2 wires Dual blue and red electric wires representing the epigastric and spermatic vessels. — Bundled with the vas deferens inside the cord assembly.
Vas deferens 1 segment Segment of 9.5 Fr central venous catheter in the spermatic cord assembly. — Bundled with the vessel wires inside the cord assembly.
Iliac vessels 2 hoses Two 30 Fr polyethylene hoses painted blue and red to represent the iliac vessels. — Colour distinguishes the two iliac vessels.
Peritoneum 1 field Self-adhesive plastic field (Ioban 6648, 3M) laid over the assembled model. — Detached during pre-peritoneal dissection.
Indirect hernia sac 1 condom Condom glued to the chop; its distal portion passes through the punched hole to represent the enlarged deep inguinal orifice. — Allows sac dissection, inversion, intra-corporeal ligation, and sectioning.


Structural Parts

Part Name Qty Material Cost Notes
Endo-trainer 1 (separately purchased; reusable) Endo-trainer (Dr. ET, Servitroner, Bogotá, Colombia, or any commercial or improvised endo-trainer) with interior lighting and a built-in video camera connected to a monitor. — Hosts the assembled model; the model is the pork-chop assembly placed inside, with two models set side by side.


Build Instructions

The source paper describes the assembly through its materials list and a single construction note that residents prepare each model in approximately 25 minutes. The following verb-first sequence reconstructs the build from Hanssen et al. (2022).

  1. Obtain a pork chop preserving the hemi-vertebra with its corresponding transverse process. Paint the transverse process white to represent Cooper's ligament.
  2. Position two 30 Fr polyethylene hoses, one painted blue and one painted red, to represent the iliac vessels.
  3. Run dual blue and red electric wires for the epigastric and spermatic vessels, inserting the ends of the epigastric wires into the polyethylene hoses.
  4. Insert a 9.5 Fr central venous catheter segment to represent the vas deferens, bundled with the vessel wires inside the spermatic cord assembly.
  5. Punch a 2 cm diameter hole in the chop using a number 11 scalpel blade to represent the enlarged deep inguinal orifice.
  6. Attach the condom to the chop with silicone glue, and fix the spermatic-cord wires and the vas-deferens catheter to the chop the same way. Introduce the condom's distal portion together with the cord wires and the catheter through the punched hole to represent the indirect hernia sac and the cord structures passing through the enlarged deep orifice.
  7. Cover the entire assembled model with a self-adhesive plastic field (Ioban 6648, 3M) to represent the peritoneum.
  8. Construct a second model in the same way and place the two side by side to represent both inguinal regions.
  9. Place the assembled pair inside the endo-trainer (Dr. ET, Servitroner, Bogotá, Colombia, or any commercial or improvised endo-trainer) with interior lighting and the built-in video camera connected to a monitor.



References

  1. ↑ Hanssen A, Hanssen DA, Hanssen RA, Plotnikov S, Haddad J, Daes JE. Implementation and Validation of a Novel and Inexpensive Training Model for Laparoscopic Inguinal Hernia Repair. J Abdom Wall Surg 2022;1:10305. DOI 10.3389/jaws.2022.10305. CC BY 4.0.
  2. ↑ Kurashima Y, Feldman L, Al-Sabah S, Kaneva P, Fried G, Vassiliou M. A novel low-cost simulator for laparoscopic inguinal hernia repair. Surg Innov 2011;18(2):171-5. DOI 10.1177/1553350610395949. PMID 21307013.




Simulator data



Page data
Keywords laparoscopic inguinal hernia repair, TAPP, hernia simulator, pork chop model, low-cost surgical training, Cooper's ligament, mesh fixation, surgical simulation
SDG
Authors Arturopelayo
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 4 pages link here
Views 4 page views (analytics)
Created May 18, 2026 by Arturo Pelayo
Last edit June 23, 2026 by Arturo Pelayo
Cite as Arturopelayo (2026). "TissueDB/Simulators/Laparoscopic Inguinal Hernia Repair Simulator (Hanssen)". Appropedia. Retrieved June 24, 2026.
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