Preliminary Study of a 3D-Printed High-Fidelity Simulator for the Training on the EBUS TBNA Procedure

Lung cancer is the second neoplasia for incidence and the leading cause of death from neoplasia in the world. A consolidated practice for lung cancer early diagnosis and staging is EBUS TBNA (EndoBronchial UltraSound-guided TransBronchial Needle Aspiration). Despite being a low-risk procedure, its success highly depends on the medical staff’s skills, who therefore require appropriate training. With the future aim of developing a novel realistic EBUS TBNA simulator that also allows tissue sampling, in this paper, the authors propose a simplified representation of the mediastinum to define a suitable layout. As far as the authors know, the physical commercially-available simulators have poor echogenic properties, do not allow tissue sampling, and can be quite expensive. The project was carried out within Custom3D, a joint laboratory between Careggi Hospital of Florence and the Department of Industrial Engineering of the University of Florence, under the request of the interventional pneumology ward. The model was validated by an expert medical doctor who assessed its anatomical accuracy and the suitability of its mechanical and acoustic properties. Moreover, the possibility of performing lymph node needle aspiration is an added value that promises to bring the EBUS TBNA simulation to a new level of realism.