DOI: 10.1093/bjs/znad258.057 ISSN:

1267 Application of the Low-Cost Laparoscopic Appendicectomy Simulation (LaApSi) Model for Laparoscopic Training in Low-Middle-Income-Countries (LMIC) and Its Comparison with the Laparoscopic Skills Session in the UK

B B Karki, S Katuwal, J Walshaw, A Rao, M M Rao, S Satyal
  • Surgery



To assess the LaApSi Model’s effectiveness in the surgical simulation within and outside the UK. To assess the delegates' expectations while simulating Laparoscopic Appendicectomy (LA) using LaApSi Model.


LaApSi models were developed using 3D printed mould & Silicon with a production cost under £5 pp. Within 6 months of model development, the quantitative assessment of LaApSi model was done by 18 trainees from LMICs (RCSEd endorsed Laparoscopic Course) and 29 within the UK, 2 Laparoscopic courses (LC) and 1 Intermediate Surgical Skills Course (ISS) evidenced by formal feedback which has further led to the production of the modified version.


For LMICs Lap-courses, 88.9%, n = 16 delegates agreed that the LaApSi model was able to meet their learning objectives whereas it was around 80% for UK courses. Similarly, 90%, n = 16 delegates agreed they were able to understand the General Steps Involved in LA, were more confident with LA and felt the course was relevant whereas it was around 15% less in these domains during UK Lap courses. 80.3% n = 5 delegates responded that the LaApSi model was equally effective in simulating Open Appendicectomy (OA) in a recent ISS course.


There is an unmet need for the development of a Low-Cost simulation model in LMICs and these cost-effective LaApSi models can provide a safe and standardized method for simulation training before operating on real patients. Although the model expectations were found relatively higher among UK delegates, feedback establishes a positive impact of the model among the course delegates.

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