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How I Do It: OpenTrainer, An Open-Source Laparoscopic Surgery Simulator With a Smartphone Endoscope
Arvind Nandakumar1, Maria R Hudock1, Griffin Welsh Daly1
1Department of Biomedical Engineering, Columbia University, New York, New York.
Objective:
To develop a low-cost DIY laparoscopic surgical simulator that uses a smartphone and can easily be replicated.
Design:
(1) utilize fabrication methodologies available at most university or community makerspaces (2) utilize hardware and software that is easy to access and install (3) include training modules for the Fundamentals of Laparoscopic Surgery (FLS) exam. (4) provide a framework for developing surgery training modules.
Setting:
Nonclinical collaboration between biomedical engineering and surgery departments at an academic medical center.
Participants:
N/A.
Results:
The FLS trainer, a commercial surgical simulator commonly used to prepare for the FLS exam, costs $4686.1 We designed OpenTrainer as a low-cost alternative. OpenTrainer utilizes the following materials and manufacturing methods to enable broad accessibility: a smartphone screen as the display, a smartphone-linked industrial endoscope as the camera, laser-cut acrylic as the device body, and 3D printed plastic as trocars and FLS exam modules. OpenTrainer costs less than $150 in materials (Appendix A). Design features enable easy manufacturing and use while maintaining the fidelity of traditional simulators: (1) trocars are based on an existing design from Thingiverse, (2) binding pins enable quick assembly and disassembly for portable use, and (3) the endoscope holder allows the user to adjust the viewing angle as needed. We also developed modules that replicate each FLS task: (1) 3D-printed pegs for peg transfers, (2) a gauze holder for precision cutting, and (3-5) a laser-cut EVA foam holder for ligation and suturing.
Conclusions:
By utilizing fabrication methodologies available at most university and community makerspaces, the OpenTrainer surgical simulator is readily made at low cost, enabling more trainees to access laparoscopic training, and potentially earlier in training. Within the OpenTrainer footprint, new training modules can be designed for students to practice techniques beyond the traditional FLS exam.
Competency:
Practice-Based Learning and Improvement, Medical Knowledge.
