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Hernia
Published in: Hernia 1/2020

01-02-2020 | Inguinal Hernia | Original Article

Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair

Authors: G. Ivakhov, A. Kolygin, S. Titkova, M. Anurov, A. Sazhin

Published in: Hernia | Issue 1/2020

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Abstract

Background

Transabdominal preperitoneal (TAPP) inguinal hernia repair requires the surgeon to have good manual skills in laparoscopic surgery, as well as an understanding of the laparoscopic features of the groin anatomy. This is why TAPP is considered a more difficult surgical procedure compared to open techniques. Realistic training model for TAPP inguinal hernia repair would enhance surgeons’ skills before they enter in the operation room. Our aim was to create a realistic, inexpensive, and easily reproducible model for laparoscopic TAPP inguinal hernia repair and to assess its effectiveness.

Methods

The applied TAPP inguinal hernia repair training simulator consists of a laparoscopic box and an inguinal region model placed in it. The model of the groin area is made of the porcine stomach and assembling materials. Uniaxial tensile and T-peel tests were performed to compare the mechanical properties of the porcine stomach and the human cadaver peritoneum. Thirty eight surgeons performed TAPP inguinal hernia repair using this model. Their opinions were scored on a five-point Likert scale.

Results

Close elastic modules of the porcine and human tissues (13.5 ± 4.2 kPa vs. 15.8 ± 6.7 kPa, p = 0.531) gave to trainees a realistic tissue feel and instrument usage. All participants strongly agreed that model was highly useful for TAPP inguinal hernia repair training. They also put the following points: the model as a whole 5 (3–5), simulation of anatomy 5 (3–5), simulation of dissection and mobilization 5 (3–5), and simulation of intracorporeal suture 5 (4–5).

Conclusions

We successfully created a model for TAPP inguinal hernia repair training. The model is made of inexpensive synthetic and biological materials similar to the human tissue. The model is easy to reproduce and can be used in the training programs of surgical residents.
Appendix
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Metadata
Title
Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair
Authors
G. Ivakhov
A. Kolygin
S. Titkova
M. Anurov
A. Sazhin
Publication date
01-02-2020
Publisher
Springer Paris
Keyword
Inguinal Hernia
Published in
Hernia / Issue 1/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-019-02032-5

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