TissueDB/Simulators/Acute Appendicitis Simulator
General Information

The Acute Appendicitis Simulator is a low-cost tissue module from the ALL-SAFE Acute Appendicitis curriculum. The completed model reproduces an inflamed 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 |
|---|---|
| General Information | Part of the ALL-SAFE Acute Appendicitis module of the Global Surgical Training Challenge. Full build instructions are on the ALL-SAFE source page and in the build instructions PDF.[1] |
| 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 appendicitis, and intracorporeal knot tying.[1] |
| Current Development Status | Pilot-tested as part of the ALL-SAFE Acute Appendicitis training module.[2] |
| Estimated Build Time and Cost | 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 to ligate the appendiceal artery; where they are unavailable, a hand-tied Roeder's knot is substituted.[1] |
| Version | Not stated in source. |
| 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), under the Global Surgical Training Challenge. ALL-SAFE team leads: Grace J. Kim (University of Michigan) and David R. Jeffcoach (Soddo Christian Hospital, PAACS).[1] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Appendix | 1 | Vinyl exam glove finger packed with sand or dirt | — | The firm, tightly packed glove finger gives the inflamed appendix its characteristic firmness.[1] |
| Cecum | 1 | Vinyl exam glove (inverted), bulked with cotton or gauze | — | The pouch of bowel to which the appendix attaches.[1] |
| 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.[1] |
| Appendiceal artery | 1 strand | Vessel loop or red yarn | — | The vessel the learner isolates and ligates within the mesoappendix during the procedure.[1] |
| Terminal ileum | 1 | Vinyl exam glove fingers | — | Anatomical landmark at the ileocecal junction near the base of the appendix.[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Silk ties | As needed | Silk suture or fine cord | — | Close off the unused glove fingers so the appendix finger holds its shape.[1] |
| Tape | As needed | Wide tape (duct tape or clear plastic packing tape) | — | Anchors the finished model to the base of the box trainer and reinforces the assembled parts.[1] |
Build Instructions
Phase 1: Appendix and Cecum

- 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.
- Invert the glove so the tied-off fingers are inside.
- Fill the intact 2nd finger with sand or dirt, packing tightly to simulate the firm consistency of the inflamed appendix.
- Fill the remainder of the glove with cotton balls or gauze to provide bulk for the cecum.
Phase 2: Mesoappendix

- Lay down a layer of plastic wrap on a flat work surface.
- Place the appendix-cecum model on top of the plastic wrap.
- Place a layer of cotton or gauze over the model.
- Position a vessel loop or red yarn across the cotton layer to simulate the appendiceal artery.
- Add a second layer of cotton or gauze on top of the yarn.
- Fold the plastic wrap up around the model, turning the appendix so the mesoappendix attaches to the posterior aspect.
- Add additional tape or plastic wrap for lateral reinforcement as needed.
Phase 3: Terminal Ileum

- Take a second vinyl exam glove and cut off the fingers.
- Fold the cut glove in half and secure with tape.
- Tape the folded glove to the side of the cecum to simulate the terminal ileum.
Phase 4: Securing the Model in the Trainer Box

- Use wide tape (duct tape or clear plastic tape) to secure the completed model to the base of the laparoscopic box trainer enclosure.
- Keep the tape clear of the appendix and cecum, which would otherwise interfere with the simulation.
Phase 5: Endoloops for the Procedure
- Fashion a Roeder's knot to use in place of commercial endoloops where these are not available.
- See the Roeder's knot tutorial video for step-by-step instructions on forming a Roeder's knot.
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 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. Not indexed in PubMed; primary source linked directly.
- ↑ 2.0 2.1 ALL-SAFE Consortium. ALL-SAFE Validation Evidence — Acute Appendicitis module pilot evaluation across four sites. Not indexed in PubMed; primary source linked directly.
Digital Resources
- Build Instructions PDF (source document)
- Paradigm Video — Expert performing simulated appendectomy
- Tips and Tricks Video — Laparoscopic appendectomy
- Construction Video — Simulation build
| Alternative names | ALL-SAFE Acute Appendicitis Simulation; ALL-SAFE Appendectomy Simulator |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Acute Appendicitis Simulator". Appropedia. Retrieved June 4, 2026. |