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TissueDB/Simulators/Acute Appendicitis Simulator

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Completed appendicitis model showing the appendix, cecum, mesoappendix, and terminal ileum assembled from a vinyl glove and cotton.
Completed Acute Appendicitis Simulation showing the appendix, cecum, mesoappendix, and terminal ileum. Image by ALL-SAFE Consortium; CC BY-SA 4.0.

The Acute Appendicitis Simulator is a low-cost laparoscopic appendectomy trainer built from vinyl exam gloves and other locally available materials, developed for the ALL-SAFE Acute Appendicitis curriculum.[1] The completed model reproduces the appendix with its surrounding cecum, mesoappendix, and terminal ileum, and is secured inside a laparoscopic box trainer so learners can practise a laparoscopic appendectomy.

Field Details
Features and Basic Operation Learners perform a simulated laparoscopic appendectomy on the completed model — isolating and ligating the appendiceal artery within the mesoappendix and dividing the appendix from the cecum. Subskills trained: appendectomy procedure, laparoscopic management of appendectomy, and intracorporeal knot tying.
Current Development Status Pilot-tested at four sites; among a targeted Mbingo-site sample of learners who completed the module, preliminary evidence of skill transfer to supervised live appendectomies.
Estimated Build Time and Cost
~US$2
Not stated in source.
Specialized Tools and Equipment A laparoscopic box trainer and laparoscopic instruments are required to use the model. Commercial endoloops are used during the procedure; where they are unavailable, a hand-tied Roeder's knot is substituted.
Version Version 1
Development Team Contact Information ALL-SAFE Consortium (Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital, and Mbingo Baptist Hospital), developed under the Global Surgical Training Challenge. Authors of the ALL-SAFE appendectomy validation study include Grace J. Kim (corresponding author, Department of Surgery, University of Michigan; gracejk@med.umich.edu) and David R. Jeffcoach (Soddo Christian Hospital, Ethiopia).

Source: ALL-SAFE Acute Appendicitis Simulation build instructions.

Tissues

Tissue Qty Material Cost Notes
Appendix 1 Vinyl exam glove finger packed with sand or dirt — The second glove finger, tightly packed with sand or dirt, forms the appendix.
Cecum 1 Vinyl exam glove (inverted), bulked with cotton or gauze — The pouch of bowel to which the appendix attaches.
Mesoappendix 1 Cotton or gauze wrapped in plastic wrap — The fold of tissue that carries the appendiceal artery; the learner divides it to free the appendix.
Appendiceal artery 1 strand Vessel loop or red yarn — The vessel the learner isolates and ligates within the mesoappendix during the procedure.
Terminal ileum 1 Vinyl exam glove fingers — Anatomical landmark at the ileocecal junction near the base of the appendix.

Structural Parts

Part Name Qty Material Cost Notes
Silk ties As needed Silk ties — Close the cut, inverted glove so it retains the sand and cotton fill.
Tape As needed Wide tape (duct tape or clear plastic tape) — Anchors the finished model to the base of the box trainer and reinforces the assembled parts.

Build Instructions

Phase 1: Appendix and Cecum


Diagram of the appendix-cecum complex showing the sand-packed glove finger as the appendix and cotton bulking the cecum.
The appendix-cecum complex: the sand-packed second finger of the vinyl exam glove forms the appendix and cotton bulks the cecum; the red strand is the appendiceal artery added in Phase 2. Image by the ALL-SAFE Consortium, CC BY-SA 4.0.
  1. Take a vinyl exam glove and tie off the thumb and 3rd–5th fingers using silk ties. Cut off the tied fingers above the tie.
  2. Invert the glove so the tied-off fingers are inside.
  3. Fill the intact 2nd finger with sand or dirt, packing it tightly to form the appendix.
  4. Fill the remainder of the glove with cotton balls or gauze to provide bulk for the cecum.

Phase 2: Mesoappendix


The appendix-cecum complex with a cotton mesoappendix and an embedded vessel-loop appendiceal artery before plastic-wrap closure.
Phase 2 result — the appendix-cecum complex with the cotton mesoappendix and embedded vessel-loop appendiceal artery, before final plastic-wrap closure. Image by the ALL-SAFE Consortium, CC BY-SA 4.0.
  1. Lay down a layer of plastic wrap on a flat work surface.
  2. Place the appendix-cecum model on top of the plastic wrap.
  3. Place a layer of cotton or gauze over the model.
  4. Position a vessel loop or red yarn across the cotton layer to simulate the appendiceal artery.
  5. Add a second layer of cotton or gauze on top of the yarn.
  6. Fold the plastic wrap up around the model, turning the appendix so the mesoappendix attaches to the posterior aspect.
  7. Add additional tape or plastic wrap for lateral reinforcement as needed.

Phase 3: Terminal Ileum


Folded second-glove fingers being taped to the side of the cecum to form the terminal ileum.
Phase 3 — folded second-glove fingers taped to the side of the cecum to form the terminal ileum. Image by the ALL-SAFE Consortium, CC BY-SA 4.0.
  1. Take a second vinyl exam glove and cut off the fingers.
  2. Fold the cut glove in half and secure with tape.
  3. Tape the folded glove to the side of the cecum to simulate the terminal ileum.

Phase 4: Securing the Model in the Trainer Box


Completed model with one edge marked for taping into the box trainer enclosure.
Phase 4 — the completed model with the marked edge secured with wide tape inside the box trainer enclosure. Image by the ALL-SAFE Consortium, CC BY-SA 4.0.
  1. Use wide tape (duct tape or clear plastic tape) to secure the completed model to the base of the laparoscopic box trainer enclosure.
  2. Keep the tape clear of the appendix and cecum, which would otherwise interfere with the simulation.


Phase 5: Endoloops for the Procedure

  1. Fashion a Roeder's knot to use in place of commercial endoloops where these are not available.
  2. See the Roeder's knot tutorial video for step-by-step instructions on forming a Roeder's knot.

References

  1. ↑ ALL-SAFE Consortium. ALL-SAFE Acute Appendicitis Simulation Build Instructions. Global Surgical Training Challenge; Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital, and Mbingo Baptist Hospital, 2022. Build instructions PDF and ALL-SAFE source page. Build-instruction document not indexed in PubMed; primary source linked directly.

Sources consulted for this page but not cited at a specific claim:

  • ALL-SAFE Consortium. ALL-SAFE Acute Appendicitis Simulation Build Instructions. Global Surgical Training Challenge; Pan-African Academy of Christian Surgeons, University of Michigan, Southern Illinois University, Soddo Christian Hospital, AIC Kijabe Hospital, and Mbingo Baptist Hospital, 2022. Build instructions PDF and ALL-SAFE source page. Build-instruction document not indexed in PubMed; primary source linked directly.
  • ALL-SAFE Consortium. ALL-SAFE Validation Evidence — Acute Appendicitis module pilot evaluation across four sites. Not indexed in PubMed; primary source linked directly.
  • Reynolds CW, Rooney DM, Jeffcoach DR, Barnard M, Snell MJ, El-Hayek K, Ngam BN, Bidwell SS, Anidi C, Tanyi J, Yoonhee Ryder C, Kim GJ. Evidence supporting performance measures of laparoscopic appendectomy through a novel surgical proficiency assessment tool and low-cost laparoscopic training system. Surg Endosc. 2023;37(9):7170–7177. doi:10.1007/s00464-023-10182-y. PMID 37336843.

Digital Resources

Simulator data
Alternative names ALL-SAFE Acute Appendicitis Simulation; ALL-SAFE Appendectomy Simulator


Page data
Keywords acute appendicitis, laparoscopic appendectomy, appendix, mesoappendix, terminal ileum, box trainer, ALL-SAFE, intracorporeal knot tying, low-cost simulator, TissueDB
SDG
Authors Arturopelayo
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 8 pages link here
Redirects TissueDB/Simulators/Laparoscopic Appendectomy Simulator, TissueDB/Simulators/Laparoscopic Appendectomy Model
Views 32 page views (analytics)
Created May 9, 2026 by Arturo Pelayo
Last edit August 22, 2026 by StandardWikitext bot
Cite as Arturopelayo (2026). "TissueDB/Simulators/Acute Appendicitis Simulator". Appropedia. Retrieved August 24, 2026.
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