Development of patient specific, realistic, and reusable video assisted thoracoscopic surgery simulator using 3D printing and pediatric computed tomography images.

Herein, realistic and reusable phantoms for simulation of pediatric lung video-assisted thoracoscopic surgery (VATS) were proposed and evaluated. 3D-printed phantoms for VATS were designed based on chest computed tomography (CT) data of a pediatric patient with esophageal atresia and tracheoesophageal fistula. Models reflecting the patient-specific structure were fabricated based on the CT images. Appropriate reusable design, realistic mechanical properties with various material types, and 3D printers (fused deposition modeling (FDM) and PolyJet printers) were used to represent the realistic anatomical structures. As a result, the phantom printed by PolyJet reflected closer mechanical properties than those of the FDM phantom. Accuracies (mean difference ± 95 confidence interval) of phantoms by FDM and PolyJet were 0.53 ± 0.46 and 0.98 ± 0.55 mm, respectively. Phantoms were used by surgeons for VATS training, which is considered more reflective of the clinical situation than the conventional simulation phantom. In conclusion, the patient-specific, realistic, and reusable VATS phantom provides a better understanding the complex anatomical structure of a patient and could be used as an educational phantom for esophageal structure replacement in VATS.