TissueDB/Simulators/Pediatric Inguinal Hernia Repair Simulator (Heo)

POLISHeR (Pediatric Open and Laparoscopic Integrated Simulator for Hernia Repair) is a 3D-printed pediatric inguinal hernia repair simulator that trains both open and laparoscopic repair.^[1] It uses a CT-derived, 3D-printed reusable base scaled to the proportions of a 2-year-old child and replaceable sex-specific tissue cartridges. The same platform supports open and laparoscopic repair in male and female anatomy.

The following sequence reconstructs the manufacturing and assembly information reported by Heo et al. (2025). Heo et al. remains the construction authority for this simulator.

1. Produce the CT-derived pediatric base and structural components using an industrial additive-manufacturing system capable of printing Vero White and Agilus 30 Clear.
2. Print the pelvis components, pubic tubercles, sacrum, vertebral elements, shell top, base, side walls, shell pins and connector pins in Vero White.
3. Print the deep (internal) inguinal rings and the open and laparoscopic modular cartridge frames in Vero White.
4. Print the peritoneum mold and preperitoneal-fat-wedge mold in Vero White.
5. Print the aorta, inferior vena cava, testis and three laparoscopic trocar ports in Agilus 30 Clear.

Source-reported fabrication time: the life-size base required approximately 24 hours of printing across three runs. Each modular cartridge required approximately 40 minutes of printing.

The authors identify adaptation of the design to less expensive home 3D printers as a future goal. Do not describe home-printer fabrication as the demonstrated build method.

1. Prepare the silicone-based skin representation. The source describes combinations of silicone, mesh and thread for the skin but does not assign every specific purchased product to this layer.
2. Pour silicone onto power mesh to create the thin, flexible external-oblique aponeurosis.
3. Cast the preperitoneal-fat component using its dedicated mold.
4. Fabricate the separate peritoneum component using its dedicated mold.
5. Embed red threads in silicone to construct the cremaster-muscle representation.
6. Prepare the retroperitoneum representation using the source-described silicone, mesh and thread combination.
7. Tint silicone components with the source-listed Rit Dye colours where required.

1. Place a non-lubricated condom as the hernia sac.
2. Attach the white elastic string representing the vas deferens and the red and blue nylon cords representing the testicular artery and vein anteromedially to the hernia sac using rubber cement.
3. Position the cremaster-muscle representation so that it envelops the hernia sac.
4. Add the source-described rubber, rope and thread representations for the inguinal ligament, medial umbilical ligaments and epigastric vessels.
5. Add the preperitoneal-fat, retroperitoneum, peritoneum and skin components.
6. Place the 3D-printed testis as the male anatomical landmark.
7. Pass the appropriate cartridge structures through the deep and superficial inguinal-ring region.
8. Secure the completed tissue assembly in its modular cartridge frame.

1. Assemble the female cartridge using the same modular approach.
2. Use the round-ligament representation in place of the male spermatic-cord structures.
3. Add the corresponding soft-tissue and vascular representations.
4. Secure the completed assembly in its cartridge frame.

Source-reported cartridge assembly time: an experienced pediatric surgeon assembled male and female cartridges in less than 3 minutes. A novice trainee required approximately 50 minutes on the first male-cartridge attempt, decreasing to approximately 10 minutes on subsequent attempts. These values are operator-specific and are not used as a single total build time.

1. Fit the printed skeletal components into the life-size base.
2. Position the 3D-printed aorta and inferior vena cava.
3. Secure the separately fabricated silicone peritoneum.
4. Fit the open and laparoscopic cartridge frames into the reusable base.
5. Apply Velcro tape to the underside of the lateral cartridge edges so the replaceable cartridges can be secured to either the life-size or smaller mobile base.
6. Install the three laparoscopic trocar ports when the laparoscopic configuration is required.

Source-reported assembly time: assembly of the life-size unisex base, including fitting the printed components and securing the silicone peritoneum, took approximately 15 minutes.

Editorial QA: before training, confirm that the selected cartridge is seated securely, the relevant anatomy is accessible for the intended open or laparoscopic repair, and reusable base components are stable. This QA statement is editorial and is not presented as an author-prescribed checkpoint.