Abstract
Background: Maneuvers involving two-handed techniques such as intracorporeal suturing and knot-tying during laparoscopy are intrinsically more difficult than ones performed during open surgery.
Methods: The use of simulators to practice and teach specialized techniques is established. However, simulators vary greatly, and few, as yet, represent the abdominal wall well.
Results: This study has shown that the working angle between instruments during laparoscopic cholecystectomy is 78°, and this can be increased to 117° by moving the instruments laterally. In contrast, the working angle in four trainers assessed was never greater than 77°.
Conclusions: This suggests that some maneuvers may be more difficult in trainers than at surgery. This has implications for training and the further development of more realistic simulators.
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McIntyre, R., Driver, C.P. & Miller, S.S. The anterior abdominal wall in laparoscopic procedures and limitations of laparoscopic simulators. Surg Endosc 10, 411–413 (1996). https://doi.org/10.1007/BF00191627
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DOI: https://doi.org/10.1007/BF00191627