TissueDB/Simulators/Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness)
The Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness) is a low-cost, neonatal-scale synthetic model — a 3D-printed rib cage with a silicone base, an artificial diaphragm, herniated synthetic viscera and a silicone skin — for practising minimally invasive (thoracoscopic) repair of a congenital diaphragmatic hernia.[1]
| Field | Details |
|---|---|
| Features and Basic Operation | Lets a trainee rehearse a full thoracoscopic congenital-diaphragmatic-hernia repair — placing intercostal ports, reducing the herniated bowel and suturing the diaphragmatic defect closed. The skin overlay is replaced between trainees. |
| Current Development Status | Pilot-tested — early validity evidence for test content and internal structure only; skills-transfer validity and further refinement are still needed before use as an assessment tool. |
| Estimated Build Time and Cost | US$218 |
| Specialized Tools and Equipment | For the build: an ABS 3D printer (rapid-prototyping machine) and Solidworks CAD software to design and print the rib cage. For use: standard thoracoscopic instruments and ports, and suture to close the defect. |
| Version | Version 1 |
| Development Team Contact Information | Katherine A. Barsness (Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine; corresponding author, kbarsness@luriechildrens.org), 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). |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Diaphragm | 1 | Synthetic; material not specified in source (posterior-lateral defect) | US$2 | Anchored to the rib cage with eyehooks around the 11th rib for suturing practice. The source rates the synthetic diaphragm low for material realism. The cost shown covers both the diaphragm and the herniated intestines, which the source prices together. |
| Small Intestine | Not specified in source | Synthetic; material not specified in source | — | Herniated through the diaphragmatic defect, to be reduced during the repair. The source rates these the least realistic tissue and notes poor haptic feedback. Cost is counted together with the diaphragm. |
| Skin | 1 (replaced between trainees) | Synthetic silicone rubber overlay | US$8 | Covers the whole apparatus and is the consumable part, replaced between trainees. The source rates the silicone skin 3.88 / 5 for realism. |
| 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. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Stabilising base | 1 | Platinum-cured silicone rubber | US$8 | Stabilises the 3D-printed rib cage during the simulated repair. |
| Anchor hardware (eyehooks) | Several (around the 11th rib) | Eyehooks | — | Eyehooks around the 11th rib hold the artificial diaphragm to the rib cage. Cost not separately stated in the source. |
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.
- 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.
Phase 2: 3D-print the rib cage and make the base
- Print the rib cage in acrylonitrile-butadiene-styrene (ABS) plastic on a rapid-prototyping machine.
- Make a stabilising base of platinum-cured silicone rubber to support the rib cage.
Phase 3: Assemble the diaphragm and viscera
- Make an artificial diaphragm with a posterior-lateral defect.
- Anchor the diaphragm to the rib cage with eyehooks around the 11th rib.
- Herniate the artificial intestines through the defect.
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.
Not Suitable For
- Right-sided CDH repair — only the left chest is modelled; right-sided repair needs a separate or mirrored build.
- 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.
- Haptic-fidelity training — the source rates the synthetic tissues low for realism and notes poor haptic feedback versus real neonatal tissue; the authors note that tissue with more neonatal-like haptics is needed.
References
- ↑ 1.0 1.1 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 July 13, 2026. |