Journal of Surgical Simulation 2021; 8: A: 24 - 24

Published: 30 June 2021


Meeting abstract

Special Issue: Flat elastic band: an alternative, inexpensive, invaluable material to develop models for laparoscopic suturing practice

Khalid Munir Bhatti, Afshan Khalid, John Wayman and Hari Prasad Avalapati
Corresponding author: Khalid Munir Bhatti, Health Education England North East, UK. Email:


Introduction: During COVID-19 opportunities for surgical simulation have become slim. Undoubtedly, there are ways to develop home-based platforms for laparoscopic simulation; developing clinically relevant, cheap suture models is challenging. The objective of the current study is to describe the content, face and construct validity of an elastic band-based suture model.

Methods: Using a flat elastic band, a laparoscopic suturing model was developed to simulate the four most common surgical procedures including enterotomy closure, suture cruroplasty for paraoesophageal hernia and peritoneal flap closure for right and left inguinal hernias. Every task was practiced 10 times. To document content and face validity, a short video consisting of the concept of the model, suturing tasks and an actual performance on the model was shared with surgical colleagues. Responses were collected using Survey Monkey. Using recordings of 40 sessions, data were collected to document construct validity through Kruskal-Wallis and Mann-Whitney U tests.

Results: Responses from 28 participants documented face and content validity of the suture model as there was 80-100 % agreement on various characteristics of the elastic material. Construct validity was documented by the fact that each task was unique (Kruskal-Wallis test: chi square=24, df 3, P-value =0.00). Moreover, there was a significant difference in task completion time for the first six attempts and last four attempts (median time: 23 vs. 15 minutes; sum of ranks: 570 vs 250; Mann–Whitney u= 114; P-value= 0.03)

Conclusion: A flat elastic band has potential to develop a variety of cost-effective, robust, clinically relevant and constructively valid suture models.


flat elastic band; surgical simulation; low cost model

Additional Information

This presentation was given at the SES 2020 online conference, 4 July 2020.