TissueDB/Simulators/Laparoscopic Inguinal Hernia Repair Simulator (Hanssen)
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 authors describe arrangements for other inguinal hernia types, but evaluated indirect hernia repair. In the study, models were reconditioned and reused within 24 hours while preserved under refrigeration. |
| Current Development Status | Built and evaluated with 10 third-year surgical residents over four weeks; performance improved on the simulated tasks. Transfer to patient care was not evaluated. |
| Estimated Build Time and Cost | ~US$20 ~25 minutes per model (resident average). |
| 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. The study exercise used 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). |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Epigastric vessels | 1 vessel-wire assembly | Dual blue and red electric wires representing the epigastric vessels. | — | Represents the epigastric vein and artery; the wire ends enter the iliac-vessel hoses. |
| 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 | 1 vessel-wire assembly | Dual blue and red electric wires representing the 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 for both sides | Self-adhesive plastic field (Ioban 6648, 3M) laid over the assembled pair. | — | Covers both side-by-side models as the peritoneum and is 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. |
| Epigastric vessels | 1 vessel-wire assembly | Dual blue and red electric wires representing the epigastric vessels. | — | The same epigastric-vessel assembly listed above, not an additional purchase; its wire ends enter the iliac-vessel hoses. |
| Vas deferens | 1 segment | Segment of 9.5 Fr central venous catheter in the spermatic cord assembly. | — | The same catheter segment listed in the Vas Deferens row above, not an additional purchase; it accompanies the vessel wires in the spermatic cord assembly. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Endo-trainer | 1 | 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. | — | Separately supplied, reusable host for the two side-by-side pork-chop models; any commercial or improvised endo-trainer can be used. |
| Assembly adhesive | — | Silicone glue | — | Attaches the condom that represents the indirect hernia sac to the pork chop, and fixes the spermatic-cord cables and the vas-deferens catheter to it the same way. Hanssen et al. (2022) name no brand, quantity or price. |
Build Instructions
The tissue quantities describe one inguinal side, except the plastic field, which covers the assembled pair. The repeated epigastric-vessel and vas-deferens entries identify the same components under existing tissue headings.
- Obtain a pork chop preserving the hemi-vertebra with its corresponding transverse process. Paint the transverse process white to represent Cooper's ligament.
- Position two 30 Fr polyethylene hoses, one painted blue and one painted red, to represent the iliac vessels.
- Run dual blue and red electric wires for the epigastric and spermatic vessels, inserting the ends of the epigastric wires into the polyethylene hoses.
- Insert a 9.5 Fr central venous catheter segment to represent the vas deferens, bundled with the vessel wires inside the spermatic cord assembly.
- Punch a 2 cm diameter hole in the chop using a number 11 scalpel blade to represent the enlarged deep inguinal orifice.
- 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.
- Construct a second model in the same way and place the two side by side to represent both inguinal regions.
- Cover the complete side-by-side preparation with a self-adhesive plastic field (Ioban 6648, 3M) to represent the peritoneum.
- Place and secure 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. The paper does not specify the attachment method.
Preparation, cost and study limits
The authors report about 25 minutes of preparation per model by residents, compared with several hours for the McGill Laparoscopic Inguinal Hernia Simulator (MLIHS, Kurashima et al. 2011[2]). The authors describe the materials as readily available from supermarkets or butcher shops, hardware stores and hospitals. Their approximately US$20 materials figure concerns the model; its separately supplied endo-trainer is not included.[1]
The study evaluated indirect (lateral) hernia repair, although the authors describe other possible inguinal-hernia arrangements. They included mesh fixation to familiarize trainees with the device and allow repeated exercises, rather than to prescribe fixation for every indirect hernia. They state that other fixation methods can also be practised. Trocar placement and laparoscopic access are not simulated because the trainer's existing ports are used.[1]
References
- ↑ 1.0 1.1 1.2 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.
- ↑ 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 October 3, 2026. |