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Ann R Coll Surg Engl. 2009 September; 91(6): 515.
PMCID: PMC2966208
Technical Notes and Tips
Bruce Campbell, Section Editor

Low-Cost Laparoscopic Paediatric Inguinal Hernia Repair Simulator


Laparoscopic repair of paediatric inguinal hernia is becoming increasingly popular.1 One of the techniques used involves the application of a purse-string suture around the patent deep inguinal ring and intracorporeal knot tying. We propose a simple, low-cost simulator to practice these skills.


The simulator is constructed from a 20-cm × 10-cm piece of cardboard and a surgical glove. The cardboard is folded and stapled to form a wedge. Four holes are made in one of the long surfaces of the wedge to mimic the deep inguinal ring. The glove is split down the sides and the thumb and excess material is removed. The finger stalks are pushed through the holes and the glove secured with staples (Fig. 1A). The base of the simulator is fixed with double-sided adhesive tape to the floor of a laparoscopic pelvi-trainer and suturing is practiced. The simulator is removed once suturing is completed for evaluation (Fig. 1B).

Figure 1
(A) The laparoscopic simulator; (B) inspection of satisfactory purse-string suture in situ.


There has been increasing awareness that the acquisition of new procedural skills should be undertaken outside the operating theatre.2 Intensive simulator training has been shown to improve operating time and accuracy in paediatric surgery.3 We suggest that this low-cost simulator may be used to acquire and maintain requisite skills necessary for laparoscopic paediatric inguinal hernia repair.


1. Saranga BR, Arora M, Baskaran V. Minimal access surgery of pediatric inguinal hernias: a review. 2008;22:1751–62. [PubMed]
2. Najmaldin A. Karl Storz Lecture. Skills training in pediatric minimal access surgery. 2007;42:284–9. [PubMed]
3. Poulakis V, Witzsch U, De VR, Dillenburg W, Moeckel M, Becht E. Intensive laparoscopic training: the impact of a simplified pelvic-trainer model for the urethrovesical anastomosis on the learning curve. 2006;24:331–7. [PubMed]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England