TissueDB/Simulators/Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness)
General Information
The Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness) is a low-cost, neonatal-scale synthetic model for practising minimally invasive repair of a congenital diaphragmatic hernia.[1]
| Field | Details |
|---|---|
| General Information | A low-cost synthetic model for thoracoscopic repair of a left-sided congenital diaphragmatic hernia in a term neonate. It was built because trainee exposure to this repair has fallen sharply and minimally invasive repair carries a higher recurrence rate than open repair, making off-OR practice valuable. The build needs rapid-prototyping infrastructure (an ABS 3D printer and Solidworks CAD) for the rib cage; the silicone base, diaphragm and skin are widely sourceable. As described in Barsness et al. 2013 (PMID 23789735).[1] |
| Features and Basic Operation | A neonatal-scale model of the left chest for practising minimally invasive (thoracoscopic) repair of a congenital diaphragmatic hernia. A to-scale, left-sided neonatal rib cage (50th percentile for age, with scapulae) is 3D-printed in ABS plastic from neonatal thoracic measurements and mounted on a cast silicone base. A silicone-rubber diaphragm with a posterior-lateral defect is anchored to the rib cage with eyehooks around the 11th rib; artificial intestines are herniated through the defect, and a synthetic silicone-rubber skin covers the whole apparatus. Working thoracoscopically, the trainee places ports between the ribs, reduces the herniated intestine and sutures the diaphragmatic defect closed. The skin overlay is replaced between trainees.[1] |
| Current Development Status | Peer-reviewed and pilot-validated. Barsness et al. 2013.[1] |
| Estimated Build Time and Cost | US$218.[1] |
| Specialized Tools and Equipment | For use: standard thoracoscopic instruments and ports, plus suture to close the defect (the source describes port placement, intestine reduction and suturing the diaphragm). For construction: an ABS 3D printer (rapid-prototyping machine) and Solidworks CAD software to make the rib cage, plus moulds to cast the silicone base, diaphragm and skin.[1] |
| Version | As described in Barsness et al. 2013 (Journal of Laparoendoscopic & Advanced Surgical Techniques 23(8):714–718).[1] |
| Development Team Contact Information | Katherine A. Barsness (Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine), Deborah M. Rooney (Department of Medical Education, University of Michigan Medical School) and Lauren M. Davis (Center for Simulation Technology and Immersive Learning, Northwestern University Feinberg School of Medicine).[1] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Diaphragm | 1 | Platinum-cured silicone rubber with a posterior-lateral defect | US$2 | Anchored to the rib cage with eyehooks around the 11th rib, giving a stable line for suture practice. The source notes the synthetic diaphragm has limited haptic realism.[1] |
| Small Intestine | Multiple loops | Material not specified in source | — | Herniated through the diaphragmatic defect, to be reduced during the repair. The source does not state the material and rates these the least realistic tissue, noting poor haptic feedback. Their cost is counted together with the diaphragm.[1] |
| Skin | 1 (replaced between trainees) | Synthetic silicone rubber overlay | US$8 | Covers the whole apparatus and is the consumable part, replaced between trainees.[1] |
| Bone — neonatal rib cage | 1 | ABS plastic, 3D-printed | US$200 | To-scale left-sided neonatal rib cage with scapulae (50th percentile for age), designed in Solidworks from neonatal thoracic measurements and printed in ABS. Only the left chest is modelled because left-sided repair is the dominant thoracoscopic indication; the intercostal spaces and chest dimensions are the simulated anatomy.[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Stabilising base | 1 | Platinum-cured silicone rubber (cast) | US$8 | Stabilises the 3D-printed rib cage during the simulated repair.[1] |
| Anchor hardware (eyehooks) | Several (around the 11th rib) | Commodity hardware | — | Eyehooks around the 11th rib hold the artificial diaphragm to the rib cage. Cost not separately stated in the source.[1] |
Build Instructions
Phase 1: Design the rib cage
- Obtain accurate measurements of the ribs, thoracic space and scapulae for a term neonate (50th percentile for age) from a literature review.[1]
- Use Solidworks CAD software (Dassault Systèmes SolidWorks Corp., Waltham, MA) to design a left-sided rib cage with scapulae matching neonatal thoracic dimensions. Model only the left chest, the dominant thoracoscopic indication.[1]
Phase 2: 3D-print and cast the structural parts
- Print the rib cage in acrylonitrile-butadiene-styrene (ABS) plastic on a rapid-prototyping machine.[1]
- Cast a stabilising base in platinum-cured silicone rubber.[1]
Phase 3: Assemble the diaphragm and viscera
- Make a silicone-rubber diaphragm with a posterior-lateral defect.[1]
- Anchor the diaphragm to the rib cage with eyehooks around the 11th rib.[1]
- Herniate the artificial intestines through the defect.[1]
Phase 4: Apply the skin overlay
- Cover the whole apparatus with a synthetic silicone-rubber skin. The skin is the consumable part, replaced between trainees.[1]
Not Suitable For
- Right-sided CDH repair — only the left chest is modelled; right-sided repair needs a separate or mirrored build.[1]
- High-stakes testing of trainees — only test-content and internal-structure validity were evaluated; the authors recommend further validity work before the model is used to judge trainee performance.[1]
- Haptic-fidelity training — the source rates the synthetic tissues low for realism and notes poor haptic feedback versus real neonatal tissue; pair with cadaveric or fetal-bovine experience for force calibration.[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 Barsness KA, Rooney DM, Davis LM. The development and evaluation of a novel thoracoscopic diaphragmatic hernia repair simulator. J Laparoendosc Adv Surg Tech 2013;23(8):714–718. DOI 10.1089/lap.2013.0196. PMID 23789735.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness)". Appropedia. Retrieved June 4, 2026. |