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TissueDB/Simulators/Appendectomy Simulator

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Procedure glove clipped into a plastic container at the start of appendectomy simulator construction.
Procedure glove clipped into the plastic container to begin the appendix–cecum complex. Image by the ASAP team; CC BY-SA 4.0.

The Appendectomy Simulator is a low-cost open-appendectomy trainer built from globally available materials. It layers a vinyl-and-batting anterior abdominal wall over a procedure-glove appendix–cecum–terminal ileum complex held in a small plastic container, on which learners practise the open appendectomy. It was developed by the ASAP (AMPATH Surgical App) team for the Global Surgical Training Challenge.[1]

Field Details
Features and Basic Operation Learners practise an open appendectomy on the finished model: incising and then closing the layered anterior abdominal wall, identifying the appendix within the appendix–cecum complex, ligating the appendiceal vessel in the mesoappendix, and dividing the appendix from the cecum. Building the model also rehearses simple interrupted suturing and instrument tying.[1]
Current Development Status Built and refined with resident and expert surgeons; no formal validity study (face, transfer, or clinical) is reported in the source.[3]
Estimated Build Time and Cost US$3
Specialized Tools and Equipment A needle driver and a haemostat — surgical instruments that can be borrowed from a health facility.[1]
Version Version 1
Development Team Contact Information Developed by the ASAP (AMPATH Surgical App) team for the Global Surgical Training Challenge; the course is introduced by Dr. Seno. See the ASAP Syllabus course.[1]

Tissues

Tissue Qty Material Cost Notes
Skin 1 Vinyl — Outermost layer of the abdominal wall; assembled coloured-side-down.[1]
Subcutaneous fat 1 Polyester batting (thicker layer) — The thicker fatty layer directly beneath the skin.[1]
Scarpa's fascia 1 Food-grade plastic wrap — The membranous fascia layer between the two fatty layers. The build instructions place plastic wrap here; the per-tissue record lists cotton fabric for this layer.[1][2] ⚑ Open for review: the ASAP build source names this layer only an unlabelled plastic-wrap separator and the cotton-fabric layer simply "fascia"; the finer anatomical names here and in the Aponeurosis row (Scarpa's fascia, aponeurosis) follow the secondary per-tissue record and match the separate Matthews wall model — please confirm the intended ASAP wall mapping.
Fatty tissue 1 Polyester batting (thinner layer) — The thinner fatty layer set deeper in the wall.[1]
Aponeurosis 1 Cotton fabric — The fibrous fascial sheet overlying the muscle.[1][2] ⚑ Open for review: see the Scarpa's fascia row — the ASAP build source names this cotton-fabric layer only "fascia"; "aponeurosis" follows the secondary per-tissue record, for Catherine to confirm.
Muscle 2 Cotton batting — Two layers carry drawn diagonal striations in opposing directions to show muscle-fibre orientation. The striations are drawn with a marker (the source's materials list names a red and a dark marker).[1]
Peritoneum 2 Food-grade plastic wrap — The two innermost layers lining the abdominal wall.[1]
Cecum 1 Procedure glove bulked with cotton — Body of the appendix–cecum–terminal ileum complex; the glove is inverted so the tied-off fingers sit inside.[1]
Terminal ileum 1 Procedure glove — Anatomical landmark of the complex, attached to the cecum; formed by the glove body.[1][2]
Appendix 1 Procedure glove middle finger packed with cotton stuffing — The glove's middle finger, packed with cotton to give it body, forms the appendix.[1]
Mesoappendix 1 Stocking — Wraps the appendix and carries the appendiceal vessel; the learner divides it to free the appendix.[1]
Appendiceal vessel 1 strand Yarn — The vessel threaded through the mesoappendix that the learner isolates and ligates during the appendectomy.[1]
Tenia coli 1 Surgical mask tie — Affixed along the glove to represent the anterior tenia coli of the cecum.[1]


Structural Parts

Part Name Qty Material Cost Notes
Plastic container 1 Plastic container — Reusable housing that holds and tensions the layered wall and the glove complex.[1]
Binder clips 6 Binder clips — Reusable; tension the wall layers and anchor the glove in the container.[1]

Consumables

Consumable Quantity Material Approximate Cost Notes
Suturing practice As needed Suture material — Used to build the model (the four corner stitches and to attach the mesoappendix and tenia coli) and consumed each time the learner practises suturing and ligation on the finished trainer.[1]

Build Instructions

Phase 1: Anterior Abdominal Wall


Vinyl being cut about 1 cm larger than the top of the plastic container.
Cutting the vinyl 1 cm larger than the container on all four sides. Image by the ASAP team; CC BY-SA 4.0.
  1. Cut the vinyl (skin) so it is 1 cm larger than the top of the 10 cm × 10 cm × 20 cm plastic container on all four sides.


The cut vinyl piece used as a template to cut the remaining layers.
Using the vinyl cut-out as a template for the remaining layers. Image by the ASAP team; CC BY-SA 4.0.
  1. Using the vinyl cut-out as a template, measure and cut the remaining layers: the thicker (1 cm) polyester batting, the thinner (0.5 cm) polyester batting, the cotton fabric, and two layers of cotton batting. Cut the food-grade plastic wrap larger than the other layers — it is trimmed at the end.


Diagonal fibre striations being drawn on the two cotton-batting muscle layers.
Drawing diagonal fibre striations on the two muscle layers. Image by the ASAP team; CC BY-SA 4.0.
  1. On the two cotton-batting muscle layers, draw diagonal fibre striations with a marker — on the first layer toward the upper-left corner, on the second toward the lower-left corner.
  2. Assemble the layers from external to internal: vinyl (skin), coloured-side-down; the 1 cm polyester batting (subcutaneous fat); a single larger layer of plastic wrap (Scarpa's fascia — trimmed at the end); the 0.5 cm polyester batting (fatty tissue); the cotton fabric (aponeurosis); the two cotton-batting muscle layers, each placed face-down with the striations opposing; and finally two layers of plastic wrap (peritoneum).
  3. Place a binder clip on each side to hold the layers in place.
  4. Place one simple interrupted suture in each of the four corners.
  5. Trim the excess plastic wrap from all layers.

Phase 2: Appendix–Cecum–Terminal Ileum Complex


Procedure glove clipped longitudinally into the plastic container with binder clips.
The glove clipped into the container to begin the appendix–cecum complex. Image by the ASAP team; CC BY-SA 4.0.
  1. Attach a procedure glove longitudinally in the container with four binder clips: the wrist to one end, the fourth finger to the opposite end, the fifth finger to a side, and the second finger to the opposite end.


Tying off the index finger of the glove with an instrument tie around a clamp.
Tying off the index finger by tying around a clamp. Image by the ASAP team; CC BY-SA 4.0.
  1. Tie off the index finger of the glove by tying around a clamp.


Suture-ligating the fourth and fifth fingers of the glove.
Suture-ligating the fourth and fifth fingers of the glove. Image by the ASAP team; CC BY-SA 4.0.
  1. Suture-ligate the fourth and fifth fingers of the glove.
  2. Invert the glove so all tied-off fingers are on the inside.
  3. Thin a piece of cotton to about 1 cm thick and the length of the middle finger, and place it inside the middle finger with a haemostat (do not overstuff the tip) — this forms the appendix.
  4. Cut the stocking and a length of yarn about 2 cm longer than the middle finger. Place the yarn inside the stocking and secure one end with a single interrupted suture — the stocking is the mesoappendix and the yarn is the appendiceal vessel.
  5. Fold the middle finger into thirds and clip the ends with a binder clip on the upper surface.
  6. From the distal tip, run a suture to close the finger edges, then continue it to attach the stocking along the finger — keep the yarn vessel on the side opposite the suture line, space stitches no more than 0.5 cm apart, and tie a knot near the base where the finger meets the palm.
  7. Attach the free end of the stocking on the palm side with a single interrupted suture near the thumb–palm junction; stitch the other end through the stocking and the glove and instrument-tie to cinch the mesoappendix into a rounded end.
  8. Stuff the glove with cotton balls to bulk out the cecum and terminal ileum.
  9. Attach the anterior tenia coli: cut the surgical-mask tie to the length from the base of the middle finger to the proximal end of the glove and affix it longitudinally with simple interrupted stitches.



References

[1][2]

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 ASAP (AMPATH Surgical App) team. Instructions to Build your Model, ASAP Syllabus. Global Surgical Training Challenge. ASAP build instructions and ASAP Syllabus course. Not indexed in PubMed; primary source linked directly.
  2. ↑ 2.0 2.1 2.2 2.3 AMPATH Surgical App (ASAP) Curriculum. Per-tissue simulation data for the anterior abdominal wall and the appendix–cecum–terminal ileum complex (Skin, Subcutaneous fat, Scarpa's fascia, Fatty tissue, Aponeurosis, Muscle, Peritoneum, Appendix, Cecum, Terminal ileum). SELF Materials Database, Appropedia. Not indexed in PubMed; primary source linked directly.
  3. ↑ ASAP (AMPATH Surgical App) team. Curriculum and Model Development, ASAP Syllabus, Global Surgical Training Challenge. ASAP curriculum and model development; states the low-cost model "underwent multiple rounds of iteration with resident and expert surgeons." Not indexed in PubMed; primary source linked directly.




Simulator data
Alternative names ASAP Appendectomy Model; Open Appendectomy Simulator; AMPATH Surgical App Appendectomy Model



Page data
Keywords open appendectomy, appendix, cecum, mesoappendix, abdominal wall layers, procedure glove model, ASAP, suturing practice, low-cost simulator, TissueDB
SDG
Authors Arturopelayo
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 20 pages link here
Views 25 page views (analytics)
Created February 11, 2026 by Felipe Schenone
Last edit June 21, 2026 by Arturo Pelayo
Cite as Arturopelayo (2026). "TissueDB/Simulators/Appendectomy Simulator". Appropedia. Retrieved June 24, 2026.
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