TR8 Developing a biological gastrojejunostomy model for laparoscopic surgical practice

Abstract

A biological gastrojejunostomy model was designed and created for practicing hand-sewn anastomosis techniques laparoscopically for general surgery SpR trainees in Ireland. This method included placing harvested sheep tripe and porcine small intestine into the laparoscopic box trainer, which enabled the trainee to practice the technique using laparoscopic instruments and dyed 3–0 vicryl suture, under the supervision of Ms. Hanley. However, a number of steps were taken to ensure that the model was ergonomically sound in order for the trainee to obtain the best possible learning outcome: The tissue was rinsed through and dried in the wet laboratory preparation room before being placed in a u–shape adjacent to each other on a dark brown felt sheet. The tissue was then fixed to the sheet of felt on either side using a surgical skin stapler. In order to avoid tissue contamination during practice, the model was subsequently placed into a plastic lipped container, which in turn was fixed into the laparoscopic box trainer with the use of Velcro strips. To ensure that the model would not advance from the container, we used Velcro sticky dots to fix the felt sheet to the plastic container. Once the model was ready for use, we then draped the laparoscopic box trainer similar to draping a surgical patient, in order to increase the simulation fidelity of the procedure. The drape being present on the box trainer also ensured that the trainee could not look through the box trainer while performing the task, which increases hand eye co-ordination application