Lap Take Home Kit

Overview

The Laparoscopic Take Home Kit is a simple box trainer style kit for trainee surgeons.

This is currently being rolled out to appropriate trainees by the RCSI.

When you have the kit you can follow these instructions to get your live feed.

 

Viewing the live camera from a PC or MAC

Connect the lead from the take home kit to the computer and wait a few seconds

Click on this button to launch the online viewer (internet connection required)

View Web Camera

If the camera feed does not start then:

Right click on the area within the grey border and click “Settings

On the second tab – ‘allow’ the camera

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On the last tab click on the camera you want to use

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You may need to have your browser allow the plugin

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You should then see the following

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Offline downloadable viewer for PC only

Download and run this application that will view the camera feed on any PC.

AMCap

Instructions for use

 

take home kit

 

 

Instruments :  1 x endoscopic curved scissors , 2 x Maryland dissector

Tasks :

Peg transfer :  1 x Peg Board , 6 x rubber objects

Suture / Intracorporeal Knot tying :      1 x one suture block, 1x  penrose drain model.

Precision Cutting  : 1 x large clip,  1 large glove , 1 circle marking template , 1 x permanent marker/pen, 1 x  foam square, 3  x small  clips.

Placement and Securing of Ligating Loop :  1 x  large clip, 1 x foam organ with appendages.

 Consumables :      

  • 25 x Penrose drain models
  • 5 x Foam organ with appendages.
  • 10 x Large gloves
  • 3 x spare Velcro strips.    

Equipment: Two Maryland graspers, pegboard, 6 rubber objects

Center the pegboard on the Velcro™ strip in the center of the trainer box.

Make sure the pegboard is centered in the camera’s field of view.

To begin, the six rubber objects are placed on the side of the pegboard corresponding to the candidate’s non-dominant hand.

peg-001

 

peg-002

Task Steps

  • The peg transfer exercise requires you to lift the six objects with a grasper/dissector, first in your non-dominant hand, and to transfer the object midair to your dominant hand.
  • Then, place each object on a peg on the opposite side of the board. There is no importance placed on the color of the objects or the order in which they are placed.
  • Once all six objects have been transferred, the process is reversed.
  • Each object is lifted in turn using the dominant hand from the pegboard, transferred midair to the other hand and placed on the pegs on the original side of the board.
  • Each transfer must be mid-air, without using the pegs or block for assistance.

Task Two: Precision Cutting

Equipment: One Maryland dissector/grasper, one endoscopic scissors,

1 x large clip,  1 large glove , 1 circle marking template , 1 x permanent marker/pen, 1 x  foam square, 3  x small  clips

This exercise requires you to cut out a circle from a glove suspended between clips.

Step 1 : Place the large white clip on the Velcro™ strip at the top of the trainer box.

Step 2: Place the foam square into the glove.

pre-001

 

Step 3: Tension glove surface using large and small clips.

pre-002

Step 4 : Mark out circle on glove using circle template and marker.

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Step 5 : perform task, one hand should be used to provide traction on the glove using the grasper and to place the glove at the best possible angle to the cutting hand.

pre-005

 

Equipment: One grasper (choice of Maryland grasper/dissector or grasper with locked/ratcheted

handle), one endoscopic scissors, one large clip, one pre-tied ligating loop or endoloop, one foam

organ with appendages.

 

 

Place the clip on the lower Velcro™ strip in the center of the square marked on the floor of the box

ensuring it’s in the center of the camera’s field of view.

Place the foam organ in the clip so that the appendages are free and visible in the field of view.

 

In this task, you are required to place a pre-tied ligating loop or endoloop around a tubular foam

appendage and secure the knot on the provided mark. Once you have inserted the endoloop into the  field of view, break off the end of the plastic pusher at the

scored mark. Once you have positioned the endoloop properly, secure the knot on the mark

near the base of the foam appendage by sliding the pusher rod down.

lig-001

 

Place the drain firmly on the suture block, and place the suture block on the Velcro™ strip in the center of the trainer box

This suturing task requires you to place a long suture through two marks in a longitudinally slit Penrose drain.

You are then required to tie 3 single throws extracorporeally, using the knot-pusher to secure each

throw on the drain. You must tie the knot tightly enough to close the slit in the drain. Be careful not to avulse the drain off the foam block.

sim-001