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

This is a low-cost part-task trainer for laparoscopic repair of inguinal hernia in boys (paediatric LIHR). It is assembled from a one-litre plastic bottle, two surgical gloves of contrasting colours, and two coloured elastic loops standing in for the vas deferens and the testicular artery, set inside a standard laparoscopic-trainer box.^[1]

The trainer was evaluated by paediatric and general surgeons across several university medical centres in France and Belgium and was subsequently adopted into the French National Pediatric Surgery Simulation Program (initiated 2015).^[3] The authors note their intent to assess skill transfer and retention through that programme's annual evaluations; no clinical-outcome translation study is reported in the source.^[1]

The source paper describes the assembly in §1 Materials and Methods of Duboureau et al. (2021).^[1] 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.^[1]
2. Remove the plastic ring beneath the bottle cap from the neck. Set the ring aside for use in step 6.^[1]
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.^[1]
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.^[1]
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 to represent the testicular artery. Fix both loop threads in place with adhesive tape.^[1]
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.^[1]
7. Pierce a small hole in the centre of the reserved bottle bottom using a pair of scissors.^[1]
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 (laparoscopic-trainer anchor).^[1]
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.^[1]
10. Tape the bottle tightly to the laparoscopic trainer to prevent shifting during the simulated procedure.^[1]
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).^[1]
12. Inspect the coloured inguinal-wall glove for inadvertent perforations between learners, then replace both gloves with fresh ones to reset the model. The assembled bottle structure is reusable; only the gloves and elastic loops are consumed per procedure.^[1]

^[1][3][2]