User:Arturopelayo/Sandbox/PDA Ligation Skills Trainer
General Information
This simulator trains the dissection, identification, and ligation technique for patent ductus arteriosus ligation via left thoracotomy. A hybrid design combining a 3D-printed neonatal pericardial cavity with synthetic vessel overlays and tissue-plane materials allows learners to practise the critical safety skill of recurrent laryngeal nerve identification and preservation, vessel mobilization in a confined mediastinal space, and double-ligature technique without requiring patient-specific imaging or expensive high-fidelity cardiac models. Suitable for pre-clinical training and skills rehearsal in residency programs and emerging cardiac centers.
| Field | Details |
|---|---|
| Features and Basic Operation | Not stated in source |
| Current Development Status | Not stated in source |
| Estimated Build Time and Cost | 90–120 minutes (assembly of pre-fabricated components; does not include 3D printing time), $3.30–5.75 per learner attempt (amortized base cost $2.00–3.65 + consumables $1.30–2.10). Fixed simulator base: $102–182 (reusable for 50+ attempts) |
| Specialized Tools and Equipment | Not stated in source |
| Version | Not stated in source |
| Development Team Contact Information | Not stated in source |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Arterial Wall (PDA) | 1 | Silicone elastomer tubing (4–6 mm inner diameter, 0.5–1.5 mm wall thickness) | $10–20 | Practise vessel dissection, palpation, clamping, and ligation technique on a compliant vessel that resists crushing and allows knot-tying without tearing. Visual: Partial. Tactile: Yes. |
| Aortic Arch | 1 | 3D-printed silicone or rigid resin model of neonatal aortic arch and descending aorta | Included in base cost | Orientate to major vascular anatomy and practise blunt dissection around a larger fixed structure without causing trauma. Visual: Partial. Tactile: Partial. |
| Pulmonary Artery | 1 | 3D-printed silicone or resin model of left main pulmonary artery and branches (1.5–2 mm wall thickness) | Included in base cost | Identify and avoid pulmonary artery branches during dissection; practise gentle tissue-plane separation without vascular injury. Visual: Partial. Tactile: Partial. |
| Mediastinal Connective Tissue | 1–2 sheets | Open-cell polyurethane foam (10–15 mm thickness) or loosely woven synthetic mesh simulating pleura, pericardium, and areolar tissue | $3–5 | Perform blunt and sharp dissection through loose tissue planes to expose the PDA; develop appropriate tissue-plane judgment without causing bleeding or nerve injury. Visual: Partial. Tactile: Partial. |
| Recurrent Laryngeal Nerve | 1 | Nylon monofilament (0.5–0.8 mm diameter) looped around the PDA base, fixed to the foam tissue; course marked with tissue adhesive or embroidery | $1–2 | Identify and retract the recurrent laryngeal nerve away from the operative field; practise careful dissection and nerve identification without traction injury. Visual: No. Tactile: Partial. |
| Phrenic Nerve | 1 | Nylon monofilament (0.5–0.8 mm diameter) running lateral to the mediastinal container along the pericardium; course marked with tissue pen or embroidery | $1–2 | Identify and preserve the phrenic nerve lateral to the operative field; develop spatial awareness of critical structures during dissection. Visual: No. Tactile: Partial. |
| Blood (Simulated) | 20–30 mL per fill | Food-grade red dye mixed into mineral oil or silicone fluid | $3–5 | Verify hemostasis after ligation and division; visual cue for bleeding sites and procedural endpoint. Visual: Yes. Tactile: No. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Housing and Container | ||||
| Pericardial cavity base | 1 | 3D-printed neonatal thoracic/pericardial container (rigid resin or clear acrylic mold from generic neonatal CT template) | $40–80 | Defines surgical workspace; must accommodate major vessels, foam tissue layers, and suturing space. Reusable across 50+ attempts. |
| Mediastinal tissue layer | 1–2 sheets | Open-cell polyurethane foam sheet (10–15 mm thickness) | $8–12 | Creates tissue planes; dissection target. Replaceable after wear. |
| Clear acrylic or polycarbonate lid | 1–2 | Surgical drape or adhesive-backed film for visualization during procedure | $3–5 | Allows observation without contamination; reusable. |
| Fixation and Positioning | ||||
| Vessel adhesive | 1 bottle | Medical-grade cyanoacrylate or silicone RTV sealant (5–10 mL bottle) | $8–15 | Secures silicone tubing, monofilament nerves, and foam tissue layers; lasts 20–30 setups. |
| Stainless steel wire or nylon cable ties | 10–20 | Positioning hardware for securing vessel and nerve courses | $2–4 | Reusable; allows repositioning between attempts. |
| Foam backing board | 1 | EVA foam or dense polyurethane board (30 mm thickness, 15 × 20 cm) | $5–10 | Base platform for entire assembly; absorbs surgical instrument placement. |
| Ligation and Dissection Consumables | ||||
| Silk ligature (2-0 or 3-0) | 100 cm (10–15 ligations) | Sterile surgical silk suture in 3-0 and 2-0 gauges | $8–12 | Primary ligation material; matches clinical practice. Stock for 10–15 attempts per simulator base. |
| Synthetic blood replacement | Per attempt | Food-grade red dye mixed into mineral oil or silicone fluid (20–30 mL per fill) | $3–5 | Consumable per attempt; refillable. Useful for hemostasis verification exercises. |
| Surgical Instruments (Durable) | ||||
| Micro-dissecting forceps (DeBakey) | 1–2 | Stainless steel, 5–6 inch length | $12–25 each | Reusable durable goods; essential for blunt dissection. |
| Small vascular clamps (DeBakey, Satinsky, or mosquito) | 3–4 | Stainless steel, 6–8 inch length | $8–15 each | Reusable; simulate vessel clamping without damaging silicone tubing. |
| Fine scissors (Potts or tenotomy) | 1 | Stainless steel, 5–6 inch | $10–18 | Reusable; for sharp dissection and vessel division. |
| Needle holders | 1–2 | Stainless steel, 5–6 inch, smooth jaw | $8–15 each | Reusable; for ligature tying. |
| Retractors (Army-Navy or hand retractors) | 2–3 | Stainless steel | $5–10 each | Reusable; for exposure and tissue plane management. |
| Reference and Anatomy Documentation | ||||
| Laminated neonatal PDA anatomical diagram | 1 | 8 × 10 adhesive laminate sheet (printed from reference PDF) | $2–3 | Surgical field reference; shows recurrent laryngeal nerve course, aortic arch relationship, and dissection planes. |
| Procedural checklist card | 1 | Laminated A6-size checklist of dissection steps, landmarks, and safety checks | $1–2 | Reference card for learner; guides procedural sequence. |
| Tissue layer cross-section diagram | 1 | Laminated cross-sectional diagram of mediastinal layers and critical structures | $1–2 | Educational aid; helps learner understand tissue-plane relationships. |
Build Instructions
Build instructions pending prototype validation. Detailed step-by-step assembly instructions to be completed during Phase 3 of development. Will include component sourcing, assembly sequence, tissue layer positioning, nerve course marking, and simulator orientation prior to learner use.
References
[1] [2] [3] [4] [5] [6] [7] [8]
- ↑ Kreutzer J, et al. "Effect of surgical subspecialty training on patent ductus arteriosus ligation outcomes." Journal of Thoracic and Cardiovascular Surgery. 2014. PMID 24488062.
- ↑ Corno AF, et al. "Surgical management of patent ductus arteriosus. A review of 413 cases." Journal of Cardiovascular Surgery. 1991. PMID 2709356.
- ↑ Meyn SH, et al. "Incidence, Risk Factors, and Comorbidities of Vocal Cord Paralysis After Surgical Closure of a Patent Ductus Arteriosus: A Meta-analysis." Journal of the American Academy of Audiology. 2019. PMC6348263.
- ↑ Rammohan V, et al. "Low Cost Simulator for Heart Surgery Training." Journal of Surgical Research. 2016. PMID 28076623.
- ↑ Sturm LP, et al. "Vessel Ligation Training via an Adaptive Simulation Curriculum." Journal of Surgical Education. 2014. PMC4430407.
- ↑ Hirji SA, et al. "Congenital Heart Surgery Skill Training Using Simulation Models: Not an Option but a Necessity." Journal of Thoracic and Cardiovascular Surgery. 2023. PMC9530313.
- ↑ Nwosu NJ, et al. "Congenital cardiac surgical simulation: bridging global workforce gaps and optimizing outcomes." Journal of Thoracic and Cardiovascular Surgery. 2024. PMID 39862146.
- ↑ Bhatla P, et al. "Hands-On Surgical Simulation in Congenital Heart Surgery: Literature Review and Future Perspective." Seminars in Thoracic and Cardiovascular Surgery. 2019.
| Alternative names | PDA Ligation Task Trainer Patent Ductus Arteriosus Ligation Simulator Neonatal PDA Ligation Skills Trainer |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "User:Arturopelayo/Sandbox/PDA Ligation Skills Trainer". Appropedia. Retrieved June 4, 2026. |