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Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair

  • G. IvakhovEmail author
  • A. Kolygin
  • S. Titkova
  • M. Anurov
  • A. Sazhin
Original Article



Transabdominal preperitoneal (TAPP) inguinal hernia repair requires the surgeon to have good manual skills in laparoscopic surgery, as well as an understanding of the laparoscopic features of the groin anatomy. This is why TAPP is considered a more difficult surgical procedure compared to open techniques. Realistic training model for TAPP inguinal hernia repair would enhance surgeons’ skills before they enter in the operation room. Our aim was to create a realistic, inexpensive, and easily reproducible model for laparoscopic TAPP inguinal hernia repair and to assess its effectiveness.


The applied TAPP inguinal hernia repair training simulator consists of a laparoscopic box and an inguinal region model placed in it. The model of the groin area is made of the porcine stomach and assembling materials. Uniaxial tensile and T-peel tests were performed to compare the mechanical properties of the porcine stomach and the human cadaver peritoneum. Thirty eight surgeons performed TAPP inguinal hernia repair using this model. Their opinions were scored on a five-point Likert scale.


Close elastic modules of the porcine and human tissues (13.5 ± 4.2 kPa vs. 15.8 ± 6.7 kPa, p = 0.531) gave to trainees a realistic tissue feel and instrument usage. All participants strongly agreed that model was highly useful for TAPP inguinal hernia repair training. They also put the following points: the model as a whole 5 (3–5), simulation of anatomy 5 (3–5), simulation of dissection and mobilization 5 (3–5), and simulation of intracorporeal suture 5 (4–5).


We successfully created a model for TAPP inguinal hernia repair training. The model is made of inexpensive synthetic and biological materials similar to the human tissue. The model is easy to reproduce and can be used in the training programs of surgical residents.


TAPP Training Simulation model Laparoscopy education 


Compliance with ethical standards

Conflict of interest

Georgy Ivakhov, Alexey Kolygin, Svetlana Titkova, Michail Anurov, and Alexander Sazhin have no conflicts of interest or financial ties to disclose.

Ethical approval

The study was approved by the institutional Ethics Committee of Pirogov Russian National Research Medical University.

Human and animal rights

This article does not contain any studies with human participants. No procedures were performed on animals in this study.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

Supplementary file1 (MOV 124223 kb)


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Faculty SurgeryPirogov Russian National Research Medical UniversityMoscowRussia
  2. 2.Department of Experimental SurgeryPirogov Russian National Research Medical UniversityMoscowRussia

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