Page 29 - Journal of Laparoscopic Surgery - WALS Journal

WJOLS

Smartphone/Tablet-based Laparoscopy Simulation System
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laparoscopic training. However, their utility is severely ports. The hook-shaped instruments were contrived by
impaired by exuberant prices. Virtual reality trainers, using common household objects. Multicolored rubber
in particular, by the virtue of their high original cost bands were put in the box to be used as movable objects
and maintenance expenditure are beyond the reach of a to be manipulated by the instruments.
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surgical trainee in developing nations. Box-type train- Practice session began by keeping the smartphone
ers, while being relatively cheaper than virtual reality camera in video mode with LED flash on, so that the
one, still require a conventional laparoscopic camera or interior of the box was clearly visible in the screen of
webcam and a monitor, contributing significantly to the smartphone (Fig. 3). Two hooks were now used to transfer
financial burden. the rubber bands between themselves and to maneuver
My efforts were directed at developing a low-cost them over the pillars. These sessions were duly recorded
simulator that is easy to assemble, requires minimal and later on evaluated to appreciate the efficiency gained
investment, and effectively imparts laparoscopic skills in laparoscopy skills (Fig. 4).
to the trainee. Smartphone-based laparoscopy simula-
tion system uses the camera of the smartphone as lapa-
roscopic camera, its light-emitting diode (LED) flash as
light source, and screen as the monitor, thereby reducing
the cost of the apparatus considerably. The apparatus was
intended to instill the essential laparoscopy skills, such
as depth perception, adjust to fulcrum effect, hand–eye
coordination, bimanual manipulation, and ambidexterity
in the trainees’ psyche.

MATERIALS AND METHODS
A plastic box with dimensions of 26 × 20 × 12 cm was taken
and modified into a laparoscopy simulation box (Fig. 1).
Its lid was fixed in partially open position to provide an Fig. 2: Prototype of the apparatus
inlet for instruments as well as for visualization through
the smartphone camera (Fig. 2). The floor of the box was
covered with cardboard and two pillars were installed
near the rear wall of the box to act as landmarks for
maneuvering of objects. A slot was created in the front wall
of the box to keep the smartphone in optimum position.
This optimum position was determined by visualizing the
interior of the box with the camera of smartphone running
in video mode. Two rubber disks with a central aperture
were fixed in the front wall of the box to work as the entry

Fig. 3: Apparatus while in use

Fig. 1: Schematic diagram of the apparatus Fig. 4: Interior of the apparatus as seen on smartphone screen
World Journal of Laparoscopic Surgery, January-April 2016;9(1):26-29 27