Development and validation of a new laparoscopic endotrainer for neonatal surgery and reduced spaces.

BACKGROUND:Pediatric laparoscopy box with sliding tray. Pediatric procedures have the difficulty of being performed in reduced spaces. Training in reduced spaces has proven to be different in complexity compared to adult laparoscopic endotrainers. AIM:To develop and validate a new neonatal/reduced-space endotrainer. METHODS:The simulator was tested and assessed by users with different skill levels and experience in laparoscopic pediatric surgery through an 8-item questionnaire. Construct validity was determined by evaluating the performance of each subject on nine exercises. RESULTS:A 10.5 x 10 x 18 cm acrylic simulator was created, with an internal working surface of 9 x 9 cm. An HD camera was incorporated, with a 0-180° range of movement. All exercises of a Basic Laparoscopic Training Program were adapted on a scale of 1:0.5 to fit in. From 49 participants, 42 (85.71%) answered the survey; 80.5% considered that the simulator reproduces similar conditions to procedures performed in children under one year of age; 61.1% thought that the simulator represents a difficulty identical to procedures performed in newborns; 73.7% considered that the neonatal simulator is more complicated than the adult simulator. Experts showed significantly better performance in all proposed exercises. CONCLUSION:The simulator has a high-quality image and design that allows training with basic tasks. The endotrainer permitted to discriminate between these different skill levels and was well evaluated by users with diverse surgical experience.