TissueDB/Simulators/Pediatric Inguinal Hernia Repair Simulator (Heo)
POLISHeR (Pediatric Open and Laparoscopic Integrated Simulator for Hernia Repair) is a 3D-printed, high-cost pediatric inguinal hernia repair simulator that trains both open and laparoscopic repair. It uses a printed base, modelled from a CT scan scaled to a 2-year-old's proportions, that carries replaceable, sex-specific tissue cartridges for practising the repair in both boys and girls.[1]
| Field | Details |
|---|---|
| Features and Basic Operation | Trains both open and laparoscopic repair on a single platform, with interchangeable male and female cartridges that are replaced between uses.[1] |
| Current Development Status | Pilot face-validity testing completed with six surgeons and trainees; a prospective construct- and concurrent-validity trial is planned but not yet conducted.[1] |
| Estimated Build Time and Cost | ~US$375 (full life-size base)[1] |
| Specialized Tools and Equipment | Industrial 3D printer (for the Vero white and Agilus 30 printed parts); printed silicone-casting molds; rubber cement and UV glue for cartridge assembly.[1] |
| Version | Version 1 |
| Development Team Contact Information | A multi-institutional collaboration between the Global Surgery Lab (Branch for Global Surgical Care) at the University of British Columbia, the Digital Lab at British Columbia Children's Hospital, the Department of Pediatric Surgery at Dr. von Hauner Children's Hospital (LMU Munich), and McGill University.[1] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Skin | 1 | Silicone (Ecoflex 00-30) cast over power mesh fabric | — | Resilient, suture-compatible layer also forming the external oblique aponeurosis.[1] |
| Peritoneum (hernia sac) | 1 | Non-lubricated condom | — | Chosen for its thin membranous texture and global availability; latex exam-glove fingers, latex finger cots, and plastic kitchen wrap were tested and rejected during iteration.[1] |
| Preperitoneal fat | 1 | Silicone cast in a dedicated mold | — | Modular wedge integrated into the cartridge assembly.[1] |
| Cremaster muscle | 1 | Red threads embedded in silicone | — | Envelops the hernia sac during cartridge assembly.[1] |
| Vas deferens | 1 | White elastic | — | Secured to the hernia sac with rubber cement during male-cartridge assembly.[1] |
| Testicular vessels | 1 pair | Red and blue nylon cords | — | Testicular artery and vein; secured alongside the vas deferens as the spermatic-cord contents.[1] |
| Inguinal ligament | 1 | Rubber, rope, and thread combinations | — | — |
| Medial umbilical ligaments | 1 | Rubber, rope, and thread combinations | — | — |
| Epigastric vessels | 1 | Rubber, rope, and thread combinations | — | — |
| Round ligament | 1 | Rubber, rope, and thread combinations | — | Female-cartridge equivalent of the male spermatic-cord structures.[1] |
| Testis | 1 | 3D-printed Agilus 30 clear | — | Flexible Agilus print used as an anatomic landmark in the male cartridge.[1] |
| Aorta | 1 | 3D-printed Agilus 30 clear | — | Life-size base vasculature; positioned during base assembly.[1] |
| Inferior vena cava | 1 | 3D-printed Agilus 30 clear | — | Life-size base vasculature; positioned during base assembly.[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| 3D-printed pelvis (left + right) and pubic tubercles | 1 set | Vero white | — | Skeletal landmarks for groin anatomy; printed alongside the sacrum and vertebrae (V1–V3) for the life-size base.[1] |
| 3D-printed shell and base (shell top, base, side walls, shell pins, connector pins) | 1 set | Vero white | — | Housing for the tissue cartridges; connector pins secure components during assembly.[1] |
| 3D-printed deep (internal) inguinal rings (×2) and modular cartridge frames (open, laparoscopic) | 1 set | Vero white | — | Cartridge frames receive the tissue components; the deep inguinal rings integrate into the cartridge assembly.[1] |
| 3D-printed laparoscopic trocar ports | 3 | Agilus 30 clear | — | Insertion points for laparoscopic instruments.[1] |
| Assembly hardware (Velcro tape, brass fasteners, hole punchers, suction cups, 20 cm square board, black vinyl) | as needed | Sourced externally (Amazon); not tissue-simulating | — | Securing and assembly hardware.[1] |
Consumables
| Consumable | Quantity | Material | Approximate Cost | Notes |
|---|---|---|---|---|
| Replacement tissue cartridge (per use) | 1 | Silicone, condom, and thread/cord components (see Tissues) | — | The cartridge tissues are consumed and remade for each repair; the source reports that only low-cost replacement parts are needed for repeat use.[1] |
Build Instructions
The Heo paper describes an iterative design process rather than a step-by-step protocol; the following sequence reproduces the published build from the Methods and Figures.
- Print the pelvis (left and right, with pubic tubercles), sacrum, vertebrae V1–V3, shell top, base, side walls, shell pins, connector pins, deep (internal) inguinal rings (×2), modular cartridge frames (open and laparoscopic), and the silicone-casting molds (peritoneum and preperitoneal-fat wedge) in Vero white, and print the aorta, inferior vena cava, the testis, and the laparoscopic trocar ports (×3) in Agilus 30 clear. The authors printed these parts on an industrial 3D printer and note that adapting the design for cheaper home 3D printers is a future goal, not yet achieved.[1]
- Cast Ecoflex 00-30 silicone over a layer of power mesh fabric to form resilient, suture-compatible sheets for the skin, the external oblique aponeurosis, and the retroperitoneum.[1]
- Cast Ecoflex 00-30 silicone alone in a dedicated mold to form modular preperitoneal-fat wedges.[1]
- Embed red threads in a silicone cast to simulate the cremaster muscle.[1]
- Assemble each male cartridge: attach a non-lubricated condom as the hernia sac; with rubber cement, secure the white elastic (vas deferens) and the red and blue nylon cords (testicular artery and vein) to the hernia sac so they reproduce the natural relationship of the spermatic-cord contents; add rubber, rope, and thread combinations for the inguinal ligament, medial umbilical ligaments, and epigastric vessels; and place the 3D-printed testis as an anatomic landmark. Insert these structures through the deep (internal) and superficial (external) inguinal rings. Use UV glue during assembly and tint silicone components with Rit Dye (yellow, tangerine, cherry red) as needed.[1]
- Assemble the female cartridge in the same way, using the round ligament in place of the male spermatic-cord structures.[1]
- Mount the cartridge inside the modular cartridge frame; assemble the frame into either the life-size unisex base or the smaller mobile open-repair base. Secure cartridge edges to the base with Velcro tape on the cartridge underside. Insert the laparoscopic trocar ports as needed.[1]
- Verify cartridge assembly and fit before use.[1]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 Heo K, Greaney E, Haehl J, Stunden C, Lindner A, Malik PRA, Rosenbaum DG, Muensterer O, Zakani S, Jacob J, Joharifard S. Iterative Design and Manufacturing of a 3D-Printed Pediatric Open and Laparoscopic Integrated Simulator for Hernia Repair (POLISHeR). Journal of Pediatric Surgery 2025;60:162232. DOI 10.1016/j.jpedsurg.2025.162232 PMID 40011165. CC BY-NC 4.0.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Pediatric Inguinal Hernia Repair Simulator (Heo)". Appropedia. Retrieved June 24, 2026. |