Laparoscopic Surgery

Endosim developed a realistic simulation model of common laparoscopic procedures using ex-vivo explants. A domed lid includes a rubber membrane that allows insertion of laparoscopic ports and instruments. The ex-vivo specimens used in the EASIE-R 1 or 2 model consist of porcine tissue or bovine tissue harvested at USDA inspected slaughterhouses as a byproduct of the meat production industry. The ex-vivo tissue promotes a realistic laparoscopic experience using commercially available laparoscopic devices. Of highest importance is the haptic feedback of real tissue simulation models that provide a comparable training environment as in a real patient.

Our specimens and trainer rentals are shipped express for on-time and fresh arrival. All specimens are shipped frozen and will require thawing and refrigerated storage upon arrival. Please be sure to include desired delivery date with your order.

Custom specimens are available! Please contact us if you are interested in a custom-made specimen for your hands-on workshop. Our email address is info@endosim.com. You may also fill out the custom specimen comment box at the bottom of the page.

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Natural Orifice Translumenal Endoscopic Surgery (NOTES)

For the simulation of NOTES, a complete porcine peritoneal cavity explant is used in the EASIE-R model for the simulation of endoluminal and transluminal surgical procedures.

This model is useful for the training of basic NOTES procedures, such as establishing transgastric and transcolonic access, peritoneal exploration, and tissue biopsy. For the more advanced ‘digestivist’, the EASIE-R can facilitate organ resection (cholecystectomy, distal pancreatectomy, liver lobe resection, hysterectomy, oophorectomy) or gastrointestinal anastomosis techniques (gastrojejunostomy, partial gastrectomy, colectomy). Multiple gastrotomies or colotomies can be performed in a single model. To facilitate multiple participants during gastrotomy or colotomy, each procedure ends by closing the perforation with a variety of closure devices.

In addition to the endoscopic view, surgical procedures can be observed through the clear acrylic cover. By removing the lid, a direct assessment of tissue incision, resection, and clip application can be undertaken by gross inspection of the the surgical site.

In contrast to using live animals for NOTES training, the use of ex-vivo specimens obtained from the meat industry, does not involve ethical concerns and is not subject to IRB approval.

For the simulation of laparoscopy or hybrid NOTES procedures a special cover with laparoscopic ports is used instead of the clear lid. This permits the use of commercially available laparoscopic instruments.

Skin Suture Pad

Skin samples from real porcine skin can be used to practice suturing such as closing cuts and lacerations with simple and advanced interrupted suturing, subcuticular suturing, continuous suturing, skin stapling or application of adhesive strips

Surgical Simulation Models:  

Complete Simulation Model = Trainer (hardware) + Real Tissue Specimen (software)

Our simulation models use two components: a plastic trainer (hardware) used in conjunction with a disposable ex-vivo specimen (software). Some disposable specimens are hybrid models combining plastic, silicon with real tissue. These types of models are single-use disables cartridges. The use of cartridges allows an easy setup and exchange of simulation models even without pre-experience.

Simulation Trainers (hardware) – used in conjunction with real tissue ex-vivo specimens

Surgical Location Name of Trainer Description Used commonly with which real tissue models …
Foregut & hindgut EASIE-R 1 with laparoscopic domed lid ... Basic simulation model with anatomically shaped cavity to facilitate a variety of specimens to be used for laparoscopic surgery
  • Laparoscopic cholecystectomy
  • Laparoscopic appendectomy
  • Laparoscopic Roux-en-Y gastric bypass
  • Laparoscopic Sleeve gastrectomy
  • NOTES
Foregut & hindgut EASIE-R 2 with laparoscopic lid Completely refined simulation model with flat bottom tray. This model contains a second bottom PEG board with adjustable alligator clamp to facilitate the use of organs of different type, size and shape. The alligator clamps can be adjusted to perfectly adapt to the size and type of specimen. This trainer can be used for laparoscopic and endoscopic endolumenal procedures.
  • Laparoscopic cholecystectomy
  • Laparoscopic appendectomy
  • Laparoscopic Roux-en-Y gastric bypass
  • Laparoscopic Sleeve gastrectomy
  • EMR/ESD
  • POEM
  • UGI Hemostasis
  • Twisted Sleeve
  • Zenker’s diverticulotomy
  • LGI Hemostasis
  • LGI Polypectomy
Foregut PEG Trainer Our PEG trainer includes a special lid with a rubber membrane to simulate the abdominal wall puncture for the PEG placement. The stomach is adjacent to the abdominal wall which facilitates transillumination.
  • PEG placement
Upper & Lower GI Thompson Endoscopic Skills Trainer (TEST) The Thompson Endoscopic Skills Trainer (TEST) is a portable training tool designed to assess and improve endoscopic skills. The first of its kind, the TEST is broken up into five task-oriented compartments, each of which develops a particular skill used in endoscopy. Capable of distinguishing among a wide range of skill levels, from novice to advanced endoscopist, the TEST is a safe, effective, and objective measure of ability. Additionally, as a training tool, the TEST may be used by beginner endoscopists to familiarize themselves with endoscopic maneuvering before proceeding to procedures inside patients, and by more advanced endoscopists to maintain their skills
  • Skills task trainer to facilitate 5 important basic endoscopic skills including retroversion polypectomy, grasping and loop reduction
Hindgut Proctoscopy Simulator Simulation model of the anus to be used with anus/rectum cartridges
  • Proctoscopy cartridge

Real Tissue Ex-vivo Specimens (software)

Surgical Location Name of Specimen Contains which organs… Used commonly for which procedure …
Porcine full abdominal explant Esophagus, stomach, duodenum, pancreas, ileum, liver, gallbladder, and kidneys
  • Laparoscopic or open cholecystectomy
  • Laparoscopic or open distal pancreatectomy
  • Laparoscopic hepatectomy
  • Laparoscopic hysterectomy and oophorectomy
  • Laparoscopic gastrojejunostomy
  • Laparoscpic gastrectomy
EMR/ESD Porcine ex-vivo esophagus-stomach-duodenum specimen
  • Diagnostic EGD
  • Endoscopic Mucosa Resection (EMR)
  • Endoscopic Submucosal Dissection (ESD)
  • Variceal band ligation
POEM Porcine ex-vivo esophagus-stomach-duodenum specimen with extra thick esophagus
  • POEM
Balloon Enteroscopy Porcine ex-vivo esophagus, stomach, duodenum and 6 feet of small bowel (ileum)
  • Single balloon enteroscopy
  • Double balloon enteroscopy
Stomach Defect Porcine ex-vivo esophagus-stomach-duodenum specimen with target perforations
  • Perforation closure
UGI Hemostasis Porcine ex-vivo esophagus-stomach-duodenum specimen with 6-8 bleeding vessels sutured into the anterior stomach wall Hemostasis in the upper GI tract:
  • Injection
  • Cautery
  • Clipping
  • Suturing
Twisted Sleeve Porcine ex-vivo esophagus-stomach-duodenum specimen with altered anatomy resembling the status post laparoscopic sleeve gastrectomy Twisted sleeve model realistically simulates a gastric volvulus as a complication of laparoscopic sleeve gastrectomy
Zenker’s Cartridge task trainer with ex-vivo model of an artificial pharyngoesophageal diverticulum with a pharyngeal pouch
  • Zenker diverticulotomy
Roux-en-Y Gastric Bypass Porcine ex-vivo esophagus-stomach-duodenum specimen with altered anatomy resembling the status post laparoscopic Roux-en-Y gastric bypass
  • ERCP in Roux-en-Y Gastric Bypass Anatomy
Porcine Colorectal Specimen Porcine colon and rectum with mesentery, urinary bladder, vagina, ovaries, salpinx
  • Laparoscopic colectomy
  • Laparoscopic hemicolectomy
Bovine Colorectal Specimen Bovine colon and rectum with mesentery, urinary bladder, vagina, ovaries, salpinx
  • Laparoscopic colectomy
  • Laparoscopic hemicolectomy
Bovine Colon Polyp specimen Bovine ex-vivo colon specimen with 6-8 bleeding vessels
  • Endoscopic Polypectomy in the colon
Proctoscopy Cartridge model of a porcine ex-vivo anus and rectum
  • Proctoscopy
  • Hemorrhoid ligation
  • Anal sphincter repair
Bovine colon EMR/ESD specimen Bovine ex-vivo colon specimen
  • EMR/ESD in the colon and rectum
Porcine colon EMR/ESD specimen Porcine ex-vivo colon specimen
  • EMR/ESD in the colon and rectum
Colonic stenosis Porcine ex-vivo colon specimen with simulated stenosis
  • Colon dilation and stent placement
LGI Hemostasis Porcine ex-vivo colon specimen with 6-8 bleeding vessels
  • Hemostasis in the colon or rectum
Porcine Colon Polyp specimen Porcine ex-vivo colon specimen with 6-8 bleeding vessels
  • Polypectomy in the colon
Bovine Colon Polyp specimen Bovine ex-vivo colon specimen with 6-8 bleeding vessels
  • Polypectomy in the colon