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The laparoscopic inguinal and diaphragmatic defect (LIDD) model: a validation study of a novel box trainer model

Damir Ljuhar1,2,3, Samuel Alexander4, Sarah Martin5

  • 1Department of Paediatric Surgery, Monash Children's Hospital, Clayton, VIC, 3168, Australia. dljuhar@gmail.com.

Surgical Endoscopy
|May 17, 2018
PubMed

Insights

The Laparoscopic Inguinal and Diaphragmatic Defect (LIDD) model effectively validates surgical simulation for paediatric laparoscopic procedures. This novel tool demonstrates construct and content validity, differentiating skill levels in inguinal hernia and diaphragmatic hernia repair.

Area of Science:

  • Surgical Simulation
  • Medical Education
  • Paediatric Surgery

Background:

  • Paediatric laparoscopic procedures are increasingly common, necessitating safe training environments.
  • Simulated models are crucial for developing part-procedural competency before patient contact.
  • The Laparoscopic Inguinal and Diaphragmatic Defect (LIDD) model was developed for paediatric inguinal hernia (IH) and congenital diaphragmatic hernia (CDH) repair simulation.

Purpose of the Study:

  • To assess the construct and content validity of the novel LIDD surgical simulation model.
  • To evaluate the model's effectiveness in training for paediatric laparoscopic IH and CDH repair.

Main Methods:

  • 107 participants (medical students, surgical trainees, experts) underwent validation testing.
  • Participants performed simulated laparoscopic IH and CDH repairs, assessed with a novel scoring system.
  • Content validity was evaluated by experts using a 6-point Likert scale.

Main Results:

  • The LIDD model demonstrated significant score differences between novices, trainees, and experts for both IH and CDH repairs.
  • Experts achieved significantly higher scores than trainees and novices (p < 0.05).
  • The model showed high expert-rated potential (4.8/6) and functional fidelity (4.0/6) for task completion.

Conclusions:

  • The LIDD model is a valid simulation tool for paediatric laparoscopic inguinal hernia and diaphragmatic hernia repair.
  • The model successfully differentiates skill levels among inexperienced, trainee, and expert laparoscopic surgeons.
  • Further refinement may be needed to distinguish skill levels within the intermediate trainee group.
Abstract

Keywords:
EducationLaparoscopic congenital diaphragmatic herniaLaparoscopic inguinal herniaSimulation

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