Preliminary Assessment of a Dry-Lab Model for Laparoscopic Percutaneous Inguinal Ring Suture Training

Laparoscopic percutaneous inguinal ring suturing (PIRS) is a valuable technique to repair indirect inguinal hernias in children. The aim of the study was to show the preliminary results of training in an easy-to-build dry-lab model for laparoscopic PIRS technique.

The dry-lab model consists of two surgical gloves (being the smaller inside the larger). The entry of the glove is tied with a rubber letting a 5-mm trocar within it (optic). Carbon dioxide is inflated through the trocar at 8 mmHg pressure. The four long fingers of the glove simulate four internal inguinal rings. Eighteen participants without significant laparoscopic experience were asked to visualize a video showing a laparoscopic PIRS performed in a 4-year-old girl with a right inguinal hernia followed by a video showing the same technique performed in our dry-lab model. They were then asked to repeat the procedure in each of the four fingers, and the procedures were recorded. Two surgeons using the task-specific checklists (TSCs), global rating scale of operative performance (GRS), and time for the whole procedure evaluated the performance blindly.

We found significant improvement in median TSC (P < .05) and median GRS each time the procedure was repeated (P < .05). There was significant shortening each time the procedure was repeated (P < .05), except between the third and fourth finger (P = .068).

Our dry-lab model might be a good option for starting laparoscopic PIRS training.