TissueDB/Simulators/Meckel's Diverticulectomy Simulator

The Meckel's Diverticulectomy Simulator is a low-cost laparoscopic trainer developed by the ALL-SAFE (Affordable Laparoscopic Low-cost Surgical African Education) consortium for the Global Surgical Training Challenge. Learners construct a simulation of a Meckel's diverticulum from locally available materials — a flat bed sheet, rubber bands, tape, and cardboard — for use inside a laparoscopic box trainer.^[1]

1. Cut a flat bed sheet (non-fitted) to 2.5 feet × 2 feet (76.2 cm × 60.96 cm). Thin white fabric is suitable; alternatively, a light-coloured non-printed material is sufficient.
2. Roll the sheet along the 2.5-foot side until 14 inches (35.56 cm) of unrolled sheet remains. The rolled portion forms the bowel; the unrolled portion forms the mesentery.

1. Cut 8 small holes 4 inches (10 cm) apart under the rolled section of sheet. Measure and mark the hole positions before cutting.

1. Push rubber bands through the holes and tie around to secure the roll. Cut off the remaining loops so they do not interfere with the simulation.

1. Generally, a Meckel's diverticulum ranges from 1 to 12 cm in length and is found proximal to the ileocecal valve. To simulate this, choose an end of the bowel and pull 3–6 cm of the rolled sheet outward, then secure a rubber band around it.

1. Cut pieces of tape (about 1.6 cm × 1.6 cm) and label them with the numbers 1–14. Place the numbers along the rolled section of the sheet, starting at the side of the bowel opposite to the Meckel's diverticulum, with 1 to the right of the first rubber band. Flip the sheet over and place 2 in the middle of the first two rubber bands, then continue alternating top and bottom until you reach the diverticulum end of the bowel.

1. Bunch the end of the mesentery and wrap a few rubber bands around it to form the mesentery root.

1. Cut a piece of cardboard following the Part F cutting template (338 mm × 265 mm; see page 6 of build instructions PDF for full dimensions). Pay attention to fold lines versus cut lines and the corrugation direction.

1. Bend the centre part upward and the side pieces up 4 cm from the edge. The centre flap and hole represent the root of the mesentery and hold the bowel to the floor of the trainer box.

1. Place the bunched bowel end through the hole in the holder with the odd-number side facing upward.

1. Secure the bowel to the holder with a rubber band.

1. Flip the bowel over to hide the root of the mesentery.

1. Locate the laparoscopic box trainer and turn it upside down. Insert the flaps from Part F into the slits used for the stability flaps.

1. Adjust the stability flaps to share the same slits as Part F. Adjustments may be needed to fit both the stability flaps and Part F into the same slits.

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