Research: Validation of low-cost models for minimal invasive surgery training of congenital diaphragmatic hernia and esophageal atresia.

J Pediatr Surg. 2020 Jun 13. pii: S0022-3468(20)30413-9. doi: 10.1016/j.jpedsurg.2020.05.045. [Epub ahead of print]

Validation of low-cost models for minimal invasive surgery training of congenital diaphragmatic hernia and esophageal atresia.

Bökkerink GM1Joosten M2Leijte E3Lindeboom MY4de Blaauw I3Botden SM3.

Author information



Minimal invasive surgery (MIS) is increasingly used for the correction of congenital diaphragmatic hernia (CDH) and esophageal atresia (EA). It is important to master these complex procedures, preferably preclinically, to avoid complications. The aim of this study was to validate recently developed models to train these MIS procedures preclinically.


Two low cost, reproducible models (one for CDH and one for EA) were validated during several pediatric surgical conferences and training sessions (January 2017-December 2018), used in either the LaparoscopyBoxx or EoSim simulator. Participants used one or both models and completed a questionnaire regarding their opinion on realism (face validity) and didactic value (content validity), rated on a five-point-Likert scale.


Of all 60 participants enrolled, 44 evaluated the EA model. All items were evaluated as significantly better than neutral, with means ranging from 3.7 to 4.1 (p < 0.001). The CDH model was evaluated by 48 participants. All items scored significantly better than neutral (means 3.5-3.9, p < 0.001), with exception of the haptics of the simulated diaphragm (mean 3.3, p = 0.054). Both models were considered a potent training tool (means 3.9).


These readily available and low budget models are considered a valid and potent training tool by both experts and target group participants.


Prospective study.


Level II.

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.


Congenital diaphragmatic hernia; Esophageal atresia; Low budget models; Minimal invasive surgeryPMID: 32646664 DOI: 10.1016/j.jpedsurg.2020.05.045

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