Advanced physical simulator for pediatric minimally invasive thoracoscopy training in the treatment of pulmonary sequestration.

Lung sequestration is a rare congenital anomaly characterized by an abnormal mass of lung tissue. It can occur in two forms, either intralobar, where the mass is embedded within the lung tissue, or extralobar, where it develops outside the lung's boundaries. In both cases, removal of this defect involves a complex minimally invasive procedure during which, in brief, the sequestration is isolated and removed. The surgical removal of the pulmonary sequestration represents a complex challenge for surgeons who have to deal with many critical aspects, such as the heartbeat-induced movement of the lung and, in pediatric cases, very limited operating space. For this reason, it is crucial to create a realistic training program that faithfully reproduces the operating conditions and enables surgeons to become familiar with this procedure. The simulator proposed in this work offers a higher level of anatomical realism than existing systems, including critical details such as the visceral pleura and accurately reproduce spatial relationships between anatomical structures. Moreover, the simulation of cardiac motion adds an element of complexity that simulate the challenges of surgery. The simulator was tested in a realistic operating room setup, validating its practical applicability.