104 - Learning Abdominal Anatomy Using a Homemade Laparoscope

Poster Board Number: 104
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : In the anatomy lab, the traditional way to explore the abdominal cavity in the donors previously emblemed in paraformaldehyde is by doing an extensive incision in the abdominal wall. However, in the hospital setting, the current way to explore the abdominal cavity of patients undergoing surgery is using a laparoscope. In the last decade, surgical residents have used fresh cadavers or soft preserved donors to perform learning surgeries, including laparoscopies. The discrepancy between techniques used within the laboratory and the clinic shows a disadvantage for medical students, partly driven by the equipment cost. Thus, at Creighton University, Phoenix campus, we have started using soft preserved donors for the anatomy labs with first- and second-year medical students to expose them to exploratory laparoscopy before cutting the abdominal wall using a homemade laparoscope.

Material methods
Donor: Soft preserved donor with an intact abdominal wall and no previous surgeries.
Lab instruments: two hemostats and a scalpel with a blade.
An endoscope and Light source: DEPSTECH WiFi Borescope, 5.0MP HD Wireless Endoscope, Semi-Rigid, 16-inch Focal Distance, Snake Inspection Camera with 2200mAh Battery for iOS & Android Smart Phone Tablets. 2592x1944 resolution HD inspection camera, 8.5mm probe endoscope. Additional light: LED pen flashlight
Laparoscopic instruments: at least two grasper forceps and a Verees Needle 1pc. Trocar cannula (TC): 2-3 TC 10mm and 12mm for Rigid tubbing, 2-3 TC for Grasper forceps (Diameter mm will match TC with grasper; it depends on your instruments). Update: Trocar cannula have been printed in a 3D printer.
Air source: Dual LED Digital Pressure Gauge Air Compressor Pump, regulable pressure.
Rigid Tubbing, transparent, 10mm and 12 mm diameter.
Other: electrical tape, gloves, and sutures.
(Tools will be shown in the presentation)

Procedure:
The standard procedure to perform a laparoscopy includes the following sequential steps: mini skin cutting, Veress needle insertion, insufflation, the introduction of the trocar, the introduction of a modified laparoscope, introduction of the first trocar with grasper forceps, followed by the introduction of the trocar with additional light, and introduction of the trocar with second grasper forceps, which ultimately allows for exploration of the posterior wall and abdominal content.

Conclusions:
New laparoscopes can cost 10K or more, preventing their use for anatomical educational purposes. In fact, used laparoscopes found on second-hand sites such as eBay can still cost 5K on average. Our development of a reusable homemade laparoscope is highly economical, costing approximately 100 dollars, and provides a novel approach to observing the abdominal wall (posterior view) and abdominal content. Typically, trocars and laparoscopic forceps can be acquired for free. Through its development, we have bypassed the need for expensive equipment and provided an opportunity for our medical students to look at organs from a different perspective, learn basic concepts of laparoscopic surgery, and inspire students to develop their skills – which could also be utilized by undergraduate and graduate institutions.