fls-products.com User Guide: Fundamentals of Laparoscopic Surgery Trainer System & Accessories Learn More at

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1 User Guide: Fundamentals of Laparoscopic Surgery Trainer System & Accessories Learn More at fls-products.com Limbs & Things Inc. P.O. Box 5669, Savannah, GA 46, USA

2 Fundamentals of Laparoscopic Surgery Trainer System & Accessories Limbs & Things, a leader in medical and surgical simulation for the past 5 years, has worked closely with the SAGES-ACS FLS Committee to update the FLS Trainer and is pleased to present a new series of Laparoscopic training products designed exclusively for the FLS Program. The new versatile and exciting design meets the need for gaining fundamental skills at an affordable cost. Limbs & Things offers three purchasing options for the FLS Trainer, which allow for parts such as the camera and light source to be easily replaced by the customer. The Limbs & Things FLS Trainer comes with either a USB or TV Camera to allow the trainee and training center to choose the most cost effective solution for their needs. The FLS Skin Frame is constructed from durable neoprene and uses magnets to attach to the frame securely. It has pre-incised holes for the Trocars. Rubber strips provide the FLS Trainer Box with a sturdy platform for training. The white acrylic and open ends of the trainer allow for ambient light to enter the training area. A variety of manual skills products are available for use with the FLS Trainer Box. Designed to develop the skills necessary to perform Laparoscopic Surgery.

3 Components: Trainer System Trainer Box Top Trainer Box Base Skin Frame Trocars Camera Monitor cable 7 8 Power Cable and Adaptors String and Alligator Clips

4 Components: Consumables Task One: Peg Transfer Peg Board Triangles for Peg Board Task Two: Precision Cutting Jumbo Clip Retainer Gauze Pads with Single Circle Gauze Pads with Double Circle Task Three: Ligating Loop Foam Organs Single Use Ligating Loop Multi Use Ligating Loop

5 Components: Consumables Tasks Four & Five: Knot Tying Suture Block Penrose Drain Sutures /0 Silk 90cm, 6mm ½ Circle Taperpoint Needle Components: Instruments Maryland Dissectors Graspers (Locking) Endoscissors 4 5 Needle Driver (Left and Right) Knot Pusher (Double-Ended)

6 Assembling the Trainer Box The Trainer will arrive in two halves Ensure the trainer is aligned correctly (power points and alligator clips should be at the front of the trainer) 4 Line up the holes on the top half of the model with the connecting points on the rubber sleeve on both sides of the model Gently press the top half of the model down onto the rubber connecting points on both sides. The two halves of the model are now securely fixed

7 Connecting a Monitor Note: If you have the FLS Trainer USB you will not need to connect a Monitor. Please move on to the Connecting a Laptop section of the User Guide. Attach the power cable to the power connection point and plug into a power source Attach the cable with the yellow connector to the remaining connection point 4 Ensure the power cable is connected to the Monitor and plugged into a power source Plug the other end of the yellow connector into the VIDEO/Y (green) connection on the back of the monitor.

8 Configuring the Monitor Once the trainer is linked to the monitor. The power light on the bottom right of the monitor will light up red Press the standby button on the remote control 4 The monitor should now display the camera view IF THE MONITOR IS NOT DISPLAYING THE CORRECT CHANNEL, Press the INPUT button on the remote control

9 Configuring the Monitor (Contd.) 5 6 The Input Source menu will display. If TV is selected, use the arrows on the remote to scroll down the menu 7 Select Component/AV on the Input Source Menu, and press enter on the remote control 8 After a few seconds the AV channel will display the camera view Press the Aspect button on the remote control to change the aspect ratio. There are 4 options to choose from: Normal, wide, cinema and zoom

10 Connecting a Laptop Note: If you have the FLS Trainer TV you will not need to connect a laptop. Locate the USB connection point on the side of the FLS Trainer (next to the power connection point), and plug in the USB cable Plug the USB end of the cable into the USB port in the laptop The laptop is now connected to the FLS Trainer

11 Adjusting the Camera (Slider) to Center the Image Lift the magnetic layer from the top of the trainer and remove from the trainer box Locate the single screw that holds the camera in place on the trainer box 4 Using a Phillips screwdriver, loosen the screw in order to realign the camera Slide the screw to the preferred position (looking at the monitor to check the camera view)

12 Adjusting the Camera (Slider) to Center the Image (Contd.) 5 6 The monitor view can also be adjusted by gently moving the camera unit up or down Check on the monitor that the image is displaying as required 7 8 Once the camera is in the correct position, tighten the screw to hold the camera in place Re-attach the magnetic layer to the top of the trainer

13 Setting up Task One: Peg Transfer Inside the trainer, locate the black marked box area with two strips of Velcro On the underside of each of the tasks is a layer of Velcro to attach to the trainer 4 Place the trainer firmly on the lower strip of Velcro. The velco strip should sit in the center of the task block The task should sit within the black lines of the marked box. Once attached, check the monitor and adjust if necessary

14 Setting up Task Two: Precision Cutting Inside the trainer, locate the black marked box area with two strips of velcro Place the two-ply piece of gauze with a single marked circle into the jumbo clip 4 The circle pattern should be facing up, with the open edge inside the jumbo clip, and the folded edge on the opposite side, closest to you. Make sure that the entire marked circle is outside of the clip The reverse of the jumbo clip has a covering of Velcro, to attach it to the trainer

15 Setting up Task Two: Precision Cutting (Contd.) 5 6 Place the clip with the gauze onto the upper Velcro strip (the strip located outside of the marked square) Use the alligator clips attached to the bottom of the front corners of the trainer with string to secure the bottom two corners of the gauze 7 8 Push the string through the third hole on the side of the trainer Pull the string until the alligator clip string is at the desired length

16 Setting up Task Two: Precision Cutting (Contd.) 9 0 Pull the excess string through the middle of the holes Pull the excess string through the first hole until the string is tight enough to hold the alligator clip at the desired length Setting up Task Three: Ligating Loop Inside the trainer, locate the black marked box area with two strips of velcro Place the foam organ into the jumbo clip with the three appendages hanging out the bottom of the clip with approximately half an inch of the organ inside the mouth of the clip

17 Setting up Task Three: Ligating Loop (Contd.) 4 The reverse of the jumbo clip has a covering of Velcro, to attach it to the trainer Place the clip onto the lower Velcro strip that is located inside the black marked square on the bottom of the FLS trainer. Make sure the organ is centerd in the field of view. 5 You may need to adjust the camera to make sure that there is at least half an inch of viewing area below the end of the organ s three appendages

18 Setting up Task Four & Five: Knot Tying Inside the trainer, locate the black marked box area with two strips of velcro On the underside of each of the tasks is a layer of Velcro to attach to the trainer 4 The penrose drain has Velcro on the underside. Center the penrose drain securely onto the Velcro strip on the suture block Center the penrose drain securely onto the Velcro strip on the suture block

19 Setting up Task Four & Five: Knot Tying 5 6 Place the suture block on the lower strip of Velcro, inside the black marked square The task should sit within the black lines of the marked box. Once attached, check the monitor and adjust if necessary Notes

20 Notes Part No: Issue, April Limbs & Things