Cost reductive laparoendoscopic single site surgery endotrainer and animal lab training-our methodology

Abstract

Laparoendoscopic single site surgery (LESS) is a new avenue in laparoscopic urology. The main advantage is the enhanced cosmetic benefits of single hidden scar. Lately many papers are being published on various procedures done by LESS. Like conventional laparoscopy, this approach is likely to be used more widely and hence exposure to this field is essential. However, formal training in this technique is not widely available. Expensive ports and nonavailability of endotrainer may be the factors deterring the training. We have modified the standard laparoscopic endotrainer with improvised ports, to make it suitable for single port laparoscopic training. For the animal lab training improvised ports and low cost instruments were used. Thus the overall cost of the training in LESS was reduced, and better confidence levels were achieved prior to human applications.

Figure 1

LESS endotrainer with modified port (1).

Figure 2

Modified LESS endotrainer port (2) being used for training.

Figure 3

Modified LESS endotrainer port (2).

Figure 4

Endotrainer in our center with modified single port (3).

Figure 5

Standard endotrainer with modified port (3).

Figure 6

LESS Endotrainer with modified port (3). Note the crowding of instruments.

Figure 7

LESS Endotrainer setup.

Figure 8

Single port endotrainer with angulated instruments.

Figure 9

Modified LESS port (4) lateral view.

Figure 10

Modified LESS port (4).

Figure 11

Orange dissection.

Figure 12

Chicken dissection in the LESS endotrainer.

Figure 13

Suturing in Bovine kidney.

Figure 14

LESS in live pig—in progress.

Figure 15

Modified single port in live animal.

Figure 16

Task Completion Time—Chart.