In abdominal surgery a laparoscopic approach is widely recognised as the gold-standard in most common surgical procedures. However, still open surgery is the standard of treatment for the majority of populations in low and middle-income countries. Even if laparoscopic surgery is accepted in a medical setting, its impact is limited by shortage of skilled surgeons. This shortage is due to limited access to quality box trainers. Though, there are wide range of laparoscopic simulator (in variety of shapes, training task etc.) which are commercially available. But majority of them are limited in their impact due to its cost, task validation, portability, accessibility, close relation to abdominal space, validation according to international standard of Fundamental of Laparoscopic Surgery (FLS) etc. This highlights the need for currently unavailable laparoscopic trainers which fulfils majority of the above criteria.

ARSICon 2019 where the Lap-Pack and low cost gastroscope were demonstrated

Lap-Pack (Laparoscopic Endo-trainer Pack) is an ultra-low-cost, DIY, portable laparoscopic simulator featuring compatibility with smart devices (phone, tablet, laptop etc.) designed to help increase access to laparoscopic training worldwide. Its assembly (do-it-yourself style) is extremely easy and can be done by anyone, anywhere and anytime. Some of its unique features are as follows:
(i) Easy accessible ports for introducing instruments.
(ii) Flexibility to modularly swap with silicon based abdominal skin for using with endoscopic camera.
(iii) Ability to be used with commercial smartphone/tablet/portable computer.
(iv) Easy assembly in 10 minutes.
(v) Cheap, tough, light weight, portable design with folds into a small pack.
(vi) Validated with various FLS training module task (Peg Transfer, Precision cutting, Ligating loop, extra/intra-corporeal knot).

Its performance and usability has been studied in India with medical students, junior trainees and senior surgeons rated its usability and camera features highly, regardless of training stage and economic setting, participants universally scored Lap-Pack’s lightweight and portable features highly, emphasising its employability on a global scale. This highlights its role as a valuable skill development (manual dexterity and depth perception skills etc.) component within a larger laparoscopic training scheme. Another study in the UK verifies the finding of the earlier study. Lap-Pack is poised to rise to global impact with affordable laparoscopic training equipment across any kind of economic settings.

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