Simulating the First Step: An Affordable ex vivo Tissue Model for Trocar Placement Training

Trocar placement is a critical and potentially high-risk component of minimally invasive surgery. However, early hands-on training opportunities for surgical trainees are limited. Existing simulation models often lack realistic tactile fidelity or are constrained by cost and accessibility. We developed an affordable trocar placement training model using ex vivo animal tissue and assessed trainee perceptions of confidence, technical skills, and procedural risk awareness following its use.

Our tissue-based abdominal wall simulation model was evaluated during surgical skills acquisition workshops for medical students. To simulate abdominal wall tension, fresh porcine and ovine abdominal wall tissues were tightly stretched over a 5-gallon plastic container using elastic straps. After standardized didactic instruction, the participants placed multiple trocars using the simulation models. Model fidelity and educational efficacy were assessed using an anonymous, voluntary, 5-point Likert-scale survey. Procedural confidence, perceived realism, and educational value were also evaluated.

According to the post-workshop survey analysis, 97% of the participants strongly agreed or agreed with the model's educational value, and 93% reported that the simulation model improved their self-perceived confidence in performing laparoscopic entry. High levels of perceived realism were reported for tissue resistance (92%), abdominal wall layer simulation (85%), and tactile feedback (82%). Sixty-four percent of the participants reported feeling more prepared to recognize trocar- and Veress needle-related complications. The participants expressed strong support for curriculum integration; most indicated the model enhanced their anatomical understanding and had educational value.

Our ex vivo tissue-based trocar placement simulation model provided a realistic platform for elementary laparoscopic skill training. Following workshop participation, novice learners reported high confidence, perceived technical skill development, and awareness of procedural risks. Our model represents a simulation platform for hands-on surgical training that can help bridge the gap between theoretical knowledge and operative psychomotor skills.