TissueDB/Simulators/Bowel Anastomosis Simulator (Habti)

The Bowel Anastomosis Simulator (Habti) is a low-cost trainer for practising hand-sewn small-bowel anastomosis.^[1] A 30 cm silicone small-bowel segment with a replicated mucosal surface is cast using a reusable 3D-printed mould and held for suturing in a 3D-printed tabletop clamp called the maxSIMclamp+. A single mould can cast up to four bowel segments.

Habti et al. (2021) states that the project digital files were released publicly. The current repository is:

maxSIMhealth/UdeMHSBA

Repository check — 10 September 2026: the public repository contains the bowel and clamp/mould STL assets, including the intestine, maxSIMclamp+ and mould components. The repository states that its digital assets are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International licence (CC BY-NC-SA 4.0).

The repository licence applies to the digital assets. The Habti et al. (2021) Cureus article itself is published under CC BY 4.0.

1. Obtain the development team's STL files from the public maxSIMhealth repository.
2. Prepare the files for FDM 3D printing. The development team used an Ultimaker S5.
3. Print the reusable bowel mould in PLA. The source reports approximately 720 g of PLA for one mould.
4. Print the maxSIMclamp+ components in PLA. The source reports approximately 160 g of PLA for one clamp.

Editorial QA: inspect the printed mould and clamp for obvious print defects that would prevent casting or assembly. This is a TissueDB buildability check and is not presented as an author-prescribed acceptance test.

1. Prepare Ecoflex 00-30 silicone according to the manufacturer's mixing instructions.
2. Use approximately 177 g of silicone for one 30 cm bowel segment.
3. Pour the mixed silicone into the 3D-printed bowel mould.
4. Allow the silicone to cure at room temperature.
5. Demould the silicone bowel segment after curing.

Timing note: Ecoflex 00-30 manufacturer data gives an approximately 4-hour cure time at room temperature. This is a material cure period only and is not used as the total simulator build time.

One reusable mould can produce up to four bowel segments.

Editorial QA: inspect the demoulded bowel segment for gross casting defects and confirm that its surface can be used for the planned suturing task. This is an editorial buildability check, not a source-defined pass/fail criterion.

1. Place the silicone bowel segment between the upper and lower components of the maxSIMclamp+.
2. Secure the clamp assembly using its four latching-style clamps.
3. Attach the maxSIMclamp+ to a tabletop or workbench.
4. Position the bowel segment for hand-sewn anastomosis practice.

Editorial QA: confirm that the clamp remains sufficiently stable for the planned suturing exercise. Habti et al. report that learners experienced inconsistent adhesion of the clamp's suction cups on some table surfaces; this observation does not constitute a formal source-prescribed fabrication checkpoint.

Habti et al. (2021) reports that the team was testing a version with power mesh fabric consisting of 80% nylon and 20% spandex embedded during silicone casting to reduce tearing. This was still under development at publication and is not presented as the baseline Version 1 construction.

• The silicone has greater recoil than biological bowel.
• Silicone tearing during suturing was identified as an area for improvement.
• The source did not establish how many sutures or anastomoses one silicone segment can tolerate before replacement.
• Clamp suction cups did not consistently adhere to all table surfaces.
• The 2023 study demonstrated transfer to an anesthetized porcine model; it did not test transfer to human operative performance.

• maxSIMhealth/UdeMHSBA — current public STL repository, CC BY-NC-SA 4.0