Skill Acquisition with the Peyton Approach: Building Your Own Appendix Simulator and Learning How to Use Endoloops

Objective: Many methods can be used to ligate and secure the base of the appendix during laparoscopic appendectomy. Ligature loops are favored in many places because of their low cost even though their application is more demanding than other techniques. Our aim was to develop a low-cost easy-to-build simulator model and instructional video.

Methods: With the following readily available material, a lifelike appendix can be created: an ultrasound probe cover, a piece of sponge, mashed carrots, and some ultrasound gel for lubrication. The video describes how to create the model and set up the simulator. Using the Peyton four-step approach, the skill of placing endoloops at the base of the appendix is taught.

Conclusion: The video enables trainees to build a simulator and start training this specific skill. By moving the learning curve to the laboratory, we hope to reduce procedure time of novices and increase patient safety.

Authors have received and archived patient consent for video recording and publication in advance of video recording of procedure.

No competing financial interests exist.

Runtime of video: 6 mins 44 secs