TissueDB/Simulators/Chest Tube Insertion Simulator (Man-O-War)
The Man-O-War Chest Tube Insertion Simulator is a low-cost manikin for training chest tube insertion (tube thoracostomy) and management, built from inexpensive materials that an educator can self-produce.[1] It supports the complete chest tube insertion procedure: rib palpation, syringe puncture and local anaesthesia, skin incision, blunt dissection, pleural puncture, tube placement, and suturing.
| Field | Details |
|---|---|
| Features and Basic Operation | The chest wall presents a palpable rib cage with individualised intercostal spaces and gives a flesh-like feel when palpating and inserting a drain. Each intercostal space tolerates up to 3 punctures — at least 30 insertion attempts per chest wall — and the chest-wall and pleura layers can be replaced in about 15 minutes. After insertion the model can be opened to confirm exact tube placement. |
| Current Development Status | Pilot-tested: used with emergency doctors at a Tunisian emergency-medicine congress in May 2022. The paper reports no validation study; a satisfaction survey is forthcoming. |
| Estimated Build Time and Cost | US$15 Approximately 1 hour |
| Specialized Tools and Equipment | Straight grinder — used to cut the plastic bucket between the ribs to individualise the intercostal spaces. |
| Version | Version 1 |
| Development Team Contact Information | Olfa Chakroun-Walha (corresponding author), Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia. Email: chakroun_olfa@medecinesfax.org |
Related TissueDB chest-tube models: Bettega, Brannan, and Carter. Source — every material, build step and cost on this page is drawn from Nasri et al. 2023 unless a cell notes otherwise.
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bone (ribs) | 10 (5 pairs) | Plaster Bandage | $2.50 | Plaster casting roll wrapped over the rib cores cut from the bucket wall; the source states the stiffened ribs "offer a real sensation of bones on palpation". |
| Chest-wall soft tissue (parietal wall) | 1 | Foam mattress ("extra dur", extra-firm) | $2.50 | Represents the authors' "parietal wall"; the source reports a "similar density to flesh" and "a real feeling when palpating and introducing a drain". It is the layer the learner incises, dissects and sutures. The source names only a "foam mattress ('extra dur', extra-firm)" and does not name the polymer; it states the foam was purchased from the factory. |
| Pleura (parietal) | 1 | Cellophane paper + Gaffer Tape | $3.50 | Cellophane rolled around the bucket, then gaffer tape laid along the intercostal spaces and molded over them; the source states "this assembly mimics the parietal pleura". This is the layer the learner punctures. The cost combines the source's two Table 1 lines for the assembly. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Thorax frame | 1 | Funnel-shaped plastic bucket | $3.00 | The "ribs" are drawn on and cut from the bucket walls; the bucket provides the thoracic form and the rib cores the plaster is wrapped over. |
| Support base | 1 | Basin with 5 kg white cement | $3.50 | The bucket is fixed into the cement-filled basin for stability during procedures. The source's Table 1 prices the basin, cement and screws together. |
| Fasteners | Not specified in source | Screws and nuts | — | Secure the foam chest wall to the bucket frame, so it can be unscrewed and replaced. Priced with the basin line in the source's Table 1. |
Build Instructions
Phase 1: Frame Construction
- Acquire frame. Buy a funnel-shaped plastic bucket with upper diameter 20 cm, lower diameter 35 cm, and length 30 cm (the source's figures as printed).
- Mark rib layout. Draw a rib cage on the bucket with a permanent marker. Place the sternum line in the middle and mark 5 pairs of ribs laterally on both sides. Make the ribs 2 cm wide and 10–15 cm long, leaving the intercostal spaces 2 cm wide.
- Cut intercostal spaces. Cut the plastic between the ribs with a straight grinder to individualise each intercostal space, leaving a rib cage of ribs anchored to the sternum.
✓ Verify: Each rib is individually defined with open, accessible intercostal spaces between them.
Phase 2: Tissue Layers
- Apply bone simulation. Cut a plaster casting roll into 4 cm strips lengthwise. Wrap the strips around each rib, flatten with the fingers, and overlap each pass. Allow the plaster to dry. The ribs become stiff at approximately 1 cm width.
✓ Verify: Dried ribs are rigid and palpation produces a firm, bone-like sensation.
- Apply the pleura, part one. Roll cellophane paper around the bucket.
- Apply the pleura, part two. Place gaffer tape along the intercostal spaces and mold it firmly over the spaces. This cellophane-and-tape assembly is the parietal pleura the learner punctures.
✓ Verify: Gaffer tape covers all intercostal spaces; the assembly gives consistent puncture resistance across all spaces.
- Attach chest wall. Anchor a 60 × 30 × 5 cm "extra dur" (extra-firm) foam mattress to the bucket with screws and nuts, so the chest wall can be unscrewed and replaced once its intercostal spaces have too many cuts to reuse. The source states this foam was purchased from the factory.
✓ Verify: The foam is secure, and the rib positions and intercostal spaces are palpable through it.
Phase 3: Base Assembly
- Create support base. Fill a basin with 5 kg of melted white cement, fix the bucket into the cement, and allow it to set completely before use.
✓ Verify: The simulator stands upright without external support and the base stays stable during chest-tube insertion force.
The authors report that they recorded a video demonstrating the construction and assembly of the model in detail; no link to it is given in the paper.
References
- ↑ Nasri A, Jerbi M, Karray R, Snoussi H, Samet A, Talbi A, Ksentini H, Rejeb I, Chakroun-Walha O, Rekik N (2023). "Man-O-War simulator: a Low-cost manikin for training on chest tube management." African Journal of Emergency Medicine 13(2):39–41. DOI: 10.1016/j.afjem.2023.01.004. PMID: 36864887.
| Alternative names | Man-O-War simulator |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Chest Tube Insertion Simulator (Man-O-War)". Appropedia. Retrieved July 21, 2026. |