EVIDENCE-BASED SIMULATION

 

Simulation of Laparoscopy, SILS and NOTES

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