TissueDB/Simulators/Laparoscopic Inguinal Hernia Repair Simulator (Hanssen)
General Information
This simulator is a low-cost trans-abdominal pre-peritoneal (TAPP) laparoscopic inguinal hernia repair training model. It is built around a pork chop that preserves the hemi-vertebra and its transverse process to stand in for Cooper's ligament, with electric wires and polyethylene hoses for the vessels, a central venous catheter segment for the vas deferens, and a condom for the indirect hernia sac.[1]
| Field | Details |
|---|---|
| General Information | This is a benchtop model for practising laparoscopic inguinal hernia repair by the trans-abdominal pre-peritoneal (TAPP) technique on real biological tissue at low cost. A pork chop provides the tissue substrate while simple synthetic items stand in for the cord structures, vessels, and peritoneum, so a trainee can rehearse the full repair end to end. It was developed and pilot-tested with general surgery residents; the validation data are reported in the source paper.[1] |
| 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.[1] |
| Current Development Status | Pilot-tested; built and shown valid under certain conditions and not yet independently replicated. See reference.[1] |
| Estimated Build Time and Cost | Approximately US$20.[1] |
| 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 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.[1] |
| Version | Not stated in source. |
| 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).[1] |
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 authors emphasise that the materials are accessible at any supermarket, butcher shop, hardware store, or hospital, and that any commercial or improvised endo-trainer can host the model.[1]
Tissues
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Structural Parts
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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 page 3 of 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.[1]
- Position two 30 Fr polyethylene hoses, one painted blue and one painted red, along the inferolateral aspect of the chop to represent the iliac vein and iliac artery.[1]
- Run dual blue and red electric wires alongside the iliac vessels to represent the epigastric and spermatic vessels.[1]
- Insert a 9.5 Fr central venous catheter segment to represent the vas deferens, bundled with the vessel wires inside the spermatic cord assembly.[1]
- Punch a 2 cm diameter hole in the chop using a number 11 scalpel blade to represent the enlarged deep inguinal orifice.[1]
- Attach a condom to the inguinal wall (the chop) with silicone glue and introduce its distal portion through the punched hole to represent the indirect hernia sac.[1]
- Cover the entire assembled model with a self-adhesive plastic field (Ioban 6648, 3M) to represent the peritoneum.[1]
- Construct a second model in the same way and place the two side by side to represent both inguinal regions.[1]
- 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.[1]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 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.
- ↑ 2.0 2.1 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.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Laparoscopic Inguinal Hernia Repair Simulator (Hanssen)". Appropedia. Retrieved June 4, 2026. |