TissueDB/Simulators/Pediatric Laparoscopic Inguinal Hernia Repair Simulator (Duboureau)

This is a low-cost, locally-sourced part-task trainer for laparoscopic inguinal hernia repair in boys, assembled from a one-litre plastic bottle, two contrasting-colour surgical gloves, and two coloured elastic loops standing in for the vas deferens and testicular artery, used inside a standard laparoscopic-trainer box.^[1]

The model assembles in about 15 minutes and was evaluated favourably by 55 surgeons and residents from ten university medical centres (including one in Belgium); it was subsequently adopted as a training tool in the French National Pediatric Surgery Simulation Program (initiated 2015).^[3] The authors intend to study skill transfer and retention through that programme's annual evaluations; no clinical-outcome translation study is reported. The laparoscopic-trainer box that hosts the model is a separate, assumed-available purchase and is not part of the parts cost. ⚑ Open for review: the source calls the model low-cost but states no price; the figure shown is a benchmark estimate for the model parts only — cost band/scope for Dr. Mohr.

The source paper describes the assembly in its Materials and Methods section. The verb-first sequence below reconstructs the build from the paper text.

1. Cut a one-litre (or larger) plastic bottle horizontally at two points — 7 cm below the neck and 7 cm from the bottom. Discard the intermediate cylindrical section. Reserve the bottle top (funnel with neck) and the bottle bottom.
2. Remove the plastic ring beneath the bottle cap from the neck. Set the ring aside for use in step 6.
3. Invert the bottle top (funnel) and tilt it at an angle to mimic the orientation of the inguinal canal relative to the abdominal wall.
4. Apply a coloured non-sterile surgical glove (size L or XL) over the funnel; pass the glove fingers through the bottle neck and cut them off a few centimetres below the neck. The glove now represents the inguinal wall.
5. Place two elastic loops of contrasting colours (e.g. Ethiloops or "scoubidou" lanyards) inside the bottle neck — one to represent the vas deferens, one the testicular artery. Fix both loop threads in place with adhesive tape.
6. Place a second (transparent) surgical glove over the assembled structure to represent the peritoneum; cut its fingers off a few centimetres below the bottle neck. Use the plastic ring reserved in step 2 to hold the distal ends of both folded gloves and the elastic loops tightly against the bottle.
7. Pierce a small hole in the centre of the reserved bottle bottom using a pair of scissors.
8. Knot a resistant elastic loop (or an elongated balloon) around the bottle neck. Pass the loop or balloon through the hole made in step 7 to link the bottle top (simulated inguinal canal) to the bottle bottom.
9. Place the assembled bottle at an angle inside the standard laparoscopic-trainer box so that the bottle neck is angled rather than perpendicular, matching the inguinal-canal axis relative to the abdominal wall.
10. Tape the bottle tightly to the laparoscopic trainer to prevent shifting during the simulated procedure.
11. Perform the simulated repair inside the laparoscopic-trainer box with laparoscopic instruments, following the Becmeur technique^[2] — dissect the transparent glove (peritoneum) free from the elastic loops (vas deferens and testicular artery), divide the simulated vaginal process, and close the peritoneum with an intracorporeal knot at the bottle neck (internal inguinal ring).
12. Between learners, inspect the coloured inguinal-wall glove for inadvertent perforations, then fit fresh gloves to reset the model. The assembled bottle is kept for repeated use; the source notes that another procedure is performed simply by fitting new gloves.