Checklist

This is a comprehensive list of materials required to set up a VATS simulation workstation. Proper preparation of the workstation is crucial for maximizing the training experience. This list ensures that all necessary tools are available.

Transport case

VATS Simulator. The simulator should have four installed wound retractors.
Set of Instruments. The instrument set (Basic or Advanced) should be verified based on the planned exercises.
Endoscopy System. The endoscopy system can consist of either of the following:
- Laptop & Kennedy Camera. It is strongly advised to have a backup Kennedy Camera available in case of potential malfunction
- Portable Endoscopy System. Consisting of the main unit, camera head, light cable and 30° endoscope

Simulation models

The disposable simulation models are packed and shipped in their own cardboard boxes:

Flat Lungs. Packed in boxes of 5.
Anatomical Lung. Packed in boxes of 2.

Versions...

Make sure you have the appropriate version of the lung models.

Additional items

Harmonic Shears. Harmonic 1100 with a 36 cm shaft length is ideal for VATS simulation. A 20 cm shaft length can be used as an alternative, but it is not optimal, particularly for uniportal VATS.
Endo-cutter. Echelon 45 mm with a 34 cm shaft length is the standard. Additionally, 60 mm endo-cutters and a 35 mm Powered Vascular Endo-cutter can be included to expand training options.
Reloads. At least one reload should be provided with each endo-cutter. Modified reloads can be used in most situations.

Live reloads...

Live reloads are preferred for separating parenchyma during segmentectomy training and right upper sleeve lobectomy training.
Generator. A harmonic cable and an adapter may need to be included with the generator, depending on the version of the harmonic shears being used.
Cables. The endoscopy system and generator must be connected to power using appropriate power cables with region-specific plugs or suitable adapters.

Batteries. Batteries are required to operate the Powered Echelon, Vascular stapler, and Echelon 300.
However, most flat lung exercises can be performed without actually firing the endo-cutter.
Batteries...

Batteries must not be plugged into endo-cutters during transport, as they will discharge. Additionally, there are shipping limitations for batteries that need to be considered.
Sutures. The following sutures are recommended for simulation practice:
- 4/0 monofilament (20 mm 1/2 needle, such as PDS). Used for continuous sutures on the flat lung model and general suturing.
  A similar suture with two needles is recommended for anastomosis in right upper sleeve lobectomy.
- 5/0 monofilament (17 mm 1/2 needle, such as Prolene). Used for interrupted sutures on the flat lung model and other interrupted sutures.
- Tape. Nylon tape or a strong silk suture is used to loop structures such as vessels and bronchi. Rubber loops are not suitable, as they produce excessive friction.